From implants to Sliding Genioplasty - Questions

[kavan]

Great. Let us hear how it goes.

@Kavan: Prime point relating to Gunson & his scope of Genioplasty technique (honestly makes me think that trouble of a consult isn't worth it). I've just put in an attempt for an Ortho, so waiting to see if anything transpires.

Regarding Urata, yes thank you -I've a consult setup with him in the coming months.


Cheers,

[ditterbo]

Frankly, I have 0 thoughts about his interest in FTM/MTF surgery.  My revision chin implant guy also did a lot of that stuff, didn't matter to me or the results. Deschamps is a guy that can offer you a 14mm SG with HA paste to hide the deep labiomental sulcas. That's about all there is for me to say. I've seen a few examples in his consult and they looked great.

[PloskoPlus]

Frankly, I have 0 thoughts about his interest in FTM/MTF surgery.  My revision chin implant guy also did a lot of that stuff, didn't matter to me or the results. Deschamps is a guy that can offer you a 14mm SG with HA paste to hide the deep labiomental sulcas. That's about all there is for me to say. I've seen a few examples in his consult and they looked great.

Her has no qualms about massive geniopasties, yet considers chin wings extreme.

[kavan]

Her has no qualms about massive geniopasties, yet considers chin wings extreme.

LOL. Is this a Freudian slip about a doctor who specializes in 'he/she' surgeries?   

[PloskoPlus]

LOL. Is this a Freudian slip about a doctor who specializes in 'he/she' surgeries?   

Stupid autocorrect. You know what I mean.    Anyway, he's on the craniofacial spectrum. He does orthognathic surgeries, but I don't think surgeons like him are the first choice for such surgeries (I know I'm digressing here from OPs concerns, I guess I'm addressing ditterbo).

[tim06]

@Reality

What work would you recommend to my midface and mandible. As far as my research goes there aren't much options left for me.

Regarding titanium as implant material it is a good choice but it comes with several downsides especially when used for the gonial angle. Since it isn't flexible there need to be much larger incisions then with other materials and it also means a much larger trauma for the muscles and nerves.

[fulcanelli]

What exactly are the negatives for ti implants? Is it just the larger incision and disruption to muscles? That seems pretty manageable.

Am I right in thinking that ti implants are unlikely to cause infection and do not cause bone erosion? If so it seems like the ideal material I don’t understand why it’s not used more widely. Especially as all the screws and plates used in all jaw surgery is ti anyway.

[tim06]

What exactly are the negatives for ti implants? Is it just the larger incision and disruption to muscles? That seems pretty manageable.

Am I right in thinking that ti implants are unlikely to cause infection and do not cause bone erosion? If so it seems like the ideal material I don’t understand why it’s not used more widely. Especially as all the screws and plates used in all jaw surgery is ti anyway.

After months of research it indeed appears to be a material with lots of positive features, however you rarely find any reviews of patients who got titan implants during an aesthetic surgery. One reason might be that they are said to be extremely expensive, like $12k for the implants alone. Thats what my doctor in Germany told me when I consulted him for a sliding genioplasty.

But in the example in the thread I posted some time ago I contacted the surgeon and he told me the whole surgery including the custom 3d titan implants would only cost $4k in Belgium.

[PloskoPlus]

What exactly are the negatives for ti implants? Is it just the larger incision and disruption to muscles? That seems pretty manageable.

Am I right in thinking that ti implants are unlikely to cause infection and do not cause bone erosion? If so it seems like the ideal material I don’t understand why it’s not used more widely. Especially as all the screws and plates used in all jaw surgery is ti anyway.

Ti H/W used in jaw surgery does get infected. FWIW, in Europe it's common practice to remove it 12 months after surgery. In the US, Australia, it's left in, unless it causes problems.

[dardok]

Lots of research you have there on MATERIALS. Might be time to take a detour and research PERIODONTAL PATHOGENS.

IMO, the MISSING LINK, as far as infections to ANY material goes, is that infections arise from PERIODONTAL PATHOGENS (found in the mouth, between the teeth or close to gums) that can get released into the BLOOD STREAM when a CUT is made INSIDE the mouth to place the implants. These pathogens just love to find their way to any place in the body where there is an implant.

To cut down on the probability of periodontal pathogens ruining an implant surgery, (or any surgery where cuts are made inside the mouth) get a full CLEANING (deep scaling under gum line if needed) MANY months before implants and another cleaning a few months or so before the surgery and in between be very concious that the teeth and gums are very clean and healthy.
Don't get a cleaning too close to the time of the implant surgery though.

 Prep with a lot of mouth baths like salt water rinses, hydrogen peroxide, dilute iodine solutions and any other home remedies you can find that are good for 'periodontitis' or 'gingivitis' since it is those 2 conditions that pretty much have the same/similar pathogens associated with the dental and gum conditions they cause.

 You can even search out dental practices that do a periodontal pathogen ASSAY. Doesn't hurt to have prophylactic anti-biotics before hand either.

Why do you not recommend getting a tooth cleaning a too close to a surgery?

[kavan]

Why do you not recommend getting a tooth cleaning a too close to a surgery?

Can release bad tooth bacteria into the blood stream which can land on an implant if you're getting implant surgery.

[dardok]

Can release bad tooth bacteria into the blood stream which can land on an implant if you're getting implant surgery.

Would this be the same case for an osteotomy or no?

Do you think getting a mouth cleaning 1 month before a procedure is too risky.

[kavan]

Would this be the same case for an osteotomy or no?

Do you think getting a mouth cleaning 1 month before a procedure is too risky.

When they make cuts through the mouth the bad bacteria can escape and get into the blood and then land on an implant. They can still do that for an osteotomy but the anti-biotics would have a better chance of working if one got an infection. One month before is OK. Then a lot of mouth bathing protocols before the surgery which I think Reality listed on this thread.

[dardok]

When they make cuts through the mouth the bad bacteria can escape and get into the blood and then land on an implant. They can still do that for an osteotomy but the anti-biotics would have a better chance of working if one got an infection. One month before is OK. Then a lot of mouth bathing protocols before the surgery which I think Reality listed on this thread.

Im assuming the cuts are from flossing? If I go to my dentist should I ask for a routine cleaning or the deep cleaning option (didnt know this was a thing). Or just tell them Im going to have surgery and would like by mouth sanitized.

Either way I don't floss regularly so Im assuming if I start flossing and it starts to bleed the same thing will happen so I might as well just start it now.

[kavan]

Im assuming the cuts are from flossing? If I go to my dentist should I ask for a routine cleaning or the deep cleaning option (didnt know this was a thing). Or just tell them Im going to have surgery and would like by mouth sanitized.

Either way I don't floss regularly so Im assuming if I start flossing and it starts to bleed the same thing will happen so I might as well just start it now.

My reference to 'cuts to the mouth' was about SURGICAL CUTS. Just get a dental check up with cleaning.