What Should I Do With An Eroding Chin Implant?

Q: Dr. Eppley, I have a chin implant that was placed 35 yrs ago when I was 18.  My dentist tells me that the bone has eroded behind the implant and that some teeth that are now moving in that area.  It is a silicone implant. I know I have to get it removed but can I have a new chin implant or is that that? My surgeon said to take it out and consider a new implant when it is healed but I do not want another silicone implant and there’s a lot of info on the internet stating they too have had serious bone problems with silicone chin implants. Is this common? Thank you.

A: Never confuse passive implant settling with active erosion. Chin implants do not actively erode bone, they merely respond over time to the pressure of the overlying soft tissue and something has to give. This phenomenon can particularly be seen when the implant sits too high over the softer and thinner bone cortices in front of the roots of the mandibular incisor teeth. Obviously you have an old implant that is positioned too high, which is why it is closer to the tooth roots. A properly positioned chin implant sits down on the basal bone, some distance away from the level of the tooth roots. You simply could have the implant removed, an allogeneic bone graft placed into the cortical defect and a new chin implant placed in a lower proper position if desired. Whether that should be a silicone or Medpor implant is a matter of debate. I suspect the implant is small and, because it is positioned too high, probably has little actual influence on the horizontal projection of the chin.
> What has happened is a natural long-term process that is not reflective of pathology or some mysterious substance leeching from the implant causing this bone/radiographic reaction.

Dr. Barry Eppley

Indianapolis, Indiana