Need some advice on how to improve the design of the Custom Jaw Implant

[Chiragsood]

Hey,
I am looking to get the custom Jaw Implants in July or August. The doctor has send me an STL file of my designed implants basically. The lateral projections in angles are 4mm and 6mm on each side with 15mm in vertical height addition to ramus. The anterior projection of chin is approx 10 mm. with 37mm width,.I am really concerned about the width of the chin actually as well as squareness. Also I have a history of Bimax with Lefort and BSSO albeit due to functional reasons which obviously f**ked my gonion angles bad. I have a good midfacial projection with so called anteface but my jawline looks undefined due to BSSO osteotomies. Currently at 18% BF.
My goal is have have a slender face and not overly projecting gonion angles as well as a square chin within normal range . Would like to have 85% bigonion to byzygomatic ratio ideally. Currently my skeletal measurements- byzygomatic width is 132mm and bigonion width is 107mm(including the implants).Should I increase the gonion projection more perhaps and reduce the width of chin to make it less square and more rounder.
I am new to this forum and will share my journey and results here as well as will try to see if I can get any pics of my lower face and will post them.

My doctor is actually a MaxFac surgeon and had some experience before in placing the implants. He also have given me some autonomy to design the implant myself with the CAD/CAM guy.

[Tomasjohn]

I think it can be important that the implants flare out quite a lot at the lower border of the jaw-angles. The implant-volume or/and lateral projection should decrease significantly as the implant goes up the ramus. Because of the masseter.

This is something I myself would discuss with the doctor to understand his design and reasons.


Maybe later I can add a visual explanation, right now I am busy.

My doctor is actually a MaxFac surgeon and had some experience before in placing the implants. He also have given me some autonomy to design the implant myself with the CAD/CAM guy.

Hmm is the autonomy a good thing? One could argue that the design is the difficult part where a lot of experience is needed. Idealicaly the doc should have a lot of experience with design / implant selection.

[GJ]

Wish I could help, but I know zero about these types of implants.

[kavan]

Hey,
I am looking to get the custom Jaw Implants in July or August. The doctor has send me an STL file of my designed implants basically. The lateral projections in angles are 4mm and 6mm on each side with 15mm in vertical height addition to ramus. The anterior projection of chin is approx 10 mm. with 37mm width,.I am really concerned about the width of the chin actually as well as squareness. Also I have a history of Bimax with Lefort and BSSO albeit due to functional reasons which obviously f**ked my gonion angles bad. I have a good midfacial projection with so called anteface but my jawline looks undefined due to BSSO osteotomies. Currently at 18% BF.
My goal is have have a slender face and not overly projecting gonion angles as well as a square chin within normal range . Would like to have 85% bigonion to byzygomatic ratio ideally. Currently my skeletal measurements- byzygomatic width is 132mm and bigonion width is 107mm(including the implants).Should I increase the gonion projection more perhaps and reduce the width of chin to make it less square and more rounder.
I am new to this forum and will share my journey and results here as well as will try to see if I can get any pics of my lower face and will post them.

My doctor is actually a MaxFac surgeon and had some experience before in placing the implants. He also have given me some autonomy to design the implant myself with the CAD/CAM guy.

Autonomy in design assumes one CAN do so oneself.  If you can't, you shouldn't be asking who knows who to design for you. If you're not in the capacity yourself to design, it would follow that you would not be in capacity to know if some random stranger to you on here design was good.

[crosshold]

I think it can be important that the implants flare out quite a lot at the lower border of the jaw-angles. The implant-volume or/and lateral projection should decrease significantly as the implant goes up the ramus. Because of the masseter.

This is something I myself would discuss with the doctor to understand his design and reasons.


Maybe later I can add a visual explanation, right now I am busy.

Hmm is the autonomy a good thing? One could argue that the design is the difficult part where a lot of experience is needed. Idealicaly the doc should have a lot of experience with design / implant selection.

this. the border of the mandible implant should have a sharp flare at the gonions and keep close to the edge of the border horizontally. the implants in your pic will likely give you the "bloated" look

[Chiragsood]

I think it can be important that the implants flare out quite a lot at the lower border of the jaw-angles. The implant-volume or/and lateral projection should decrease significantly as the implant goes up the ramus. Because of the masseter.

This is something I myself would discuss with the doctor to understand his design and reasons.


Maybe later I can add a visual explanation, right now I am busy.

Hmm is thtonomy a good thing? One could argue that the design is the difficult part where a lot of experience is needed. Idealicaly the doc should have a lot of experience with design / implant selection.

Thank you so very much for the reply.I would really appreciate if you can elaborate on the top a little bit please. Should I make the implant more concave in mid-mandible region and make gonions more flare out.TBH I dont want too much protrusion in angles because it can end up giving minecraft character look.

[Tomasjohn]

Thank you so very much for the reply.I would really appreciate if you can elaborate on the top a little bit please. Should I make the implant more concave in mid-mandible region and make gonions more flare out.TBH I dont want too much protrusion in angles because it can end up giving minecraft character look.

The reason why I said this is mostly because of:
a) Blog from Dr.Eppley about implant design or selection. He writes about this quite a lot. Check it out.
b) A patient from Dr.Eppley made a really informative post about the implant design process and why the implant has to flare out (according to eppley).
c) Own observation after a & b.


Super busy right now, so here is the short version. If I find time later, I will go more in depth or add the resources I mention here. But the reasoning of a & b material makes sense so check it out if you find it ... I don't say this is a general rule but its something to consider

And Minecraft Charter look is probably more due to the size of the implant then shape.

[Reality]

Autonomy in design assumes one CAN do so oneself.  If you can't, you shouldn't be asking who knows who to design for you. If you're not in the capacity yourself to design, it would follow that you would not be in capacity to know if some random stranger to you on here design was good.

This is the most sage advice. I think you’re setting yourself up for disappointment.