Will Paranasal Implants Have To Be Removed For A LeFort 1 Advancement?

Q: Dr. Eppley, I had mid-face (mid-face rim and paranasal) implants placed last year to address my facial concavity caused by my underbite. Anyway, I’m happy with the results, but I’ve finally decided to get my bite fixed via jaw surgery.

I understand that I will require a CT scan. My question is – would it be possible to ‘erase’ the implants (and their screws) from the scan, or would I have to get these implants removed prior to getting the scan so that they don’t show up?

A: If you are having orthognathic surgery, presumably a LeFort 1 advancement, you would not necessarily need a CT scan. Traditional cephalometric x-rays can be used and the implants would not interfere with assessing the tooth relationships. If one is having their surgery planned by VSP (virtual surgery planning), then a 3D CT would be needed. But the implants can be digitally removed (although that is not really necessary) to make the virtual maxillary advancement and create the splints off of stone models.

For a LeFort 1 advancement, however, the paranasal implants will be in the way and would have to be removed to make the bone cuts. But that could be done as the same time as the LeFort surgery.

Dr. Barry Eppley

Indianapolis, Indiana