What Are The Dental Concerns With A Custom Jawline Implant?

Q: Dr. Eppley, Are there any dental concerns with a custom jawline wrap? From the photos of the wrap designs it seems like they are placed close to whether the tooth roots would be, could there be issues with tooth root damage, and if there is bone erosion will that be an issue with the teeth? Also where are the screws placed, would those be in danger of coming into contact with a root as as well? The same question applies to a sliding genioplasty, as the screws are placed close to the tooth roots, how do you make sure in surgery that the screw will not come into contact with the roots? 

Ive also seen online that the jaw shrinks as we age, how would this effect the fit of a custom wraparound implant? 

A: In answer to your custom jawline implant questions:

1) There are no dental concerns with such implants.

2) The tooth roots and most of the length of the inferior alveolar nerve lies within the mandiboe while the implant sits on the outside of the bone.

3) Bone erosion does not occur with jawline implants which is often confused with passive biologic implant settling. The tooth roots are not at risk.

4) Small 2.0mm titanium screws are used which penetrate 1 to 2mms into the bone, well away from the tooth roots and nerve.

5) The superior screws of a sliding genioplasty penetyrate into the outer cortical bone below the tooth roots of the incisors which have the shortest roots of any tooth in the enture dental arch.

6) The jaw only shrinks with age if some or all of the teeth are lost. It doesn’t lose bone mass because of age, it loses it because of loss of functional loading.

Dr. Barry Eppley

World-Renowned Plastic Surgeon