Should I get hydroxyapatite jaw angle implants during my double jaw surgery?

[bbmray]

I have a short ramus and I'm not sure the pros and cons to getting the jaw angle implants offered to me by my surgeon who's used them a lot. I have an overbite and am getting a double jaw surgery with CCW rotation to move both jaws forward (lower one more so)

My surgeon recently asked if i wanted to get hydroxyapatite block jaw angle implants (elbow-shaped) put on during the surgery as well.

Are they hard to remove years later if I decide I want different shaped implants? (I assume I can't put implants on top of them.) Are the angles likely to become asymmetric?  Are they bad for autoimmune reasons since they're so bumpy?

Thanks!

[GJ]

I've never seen good results with HA, nor have I heard from any patients who like them. Seems like a good way to fatten up the surgical bill, though.

[PloskoPlus]

HA causes a lot of inflammation.  It's almost impossible to remove.

[kavan]

NOTE:

The HA that causes a lot of the inflammation is the HA PASTE or HA granules; a substance that is mixed and spread onto an area. The OP in this string is NOT referring to that. He is referring to a jaw angle implant which can either be pre-fabricated or carved from a BLOCK of HA. In fact HA paste cannot be used to ELONGATE the ramus. Only a JAW IMPLANT can do that. So the OP is clearly not referring to the stuff that kicks up a lot of inflammation which is the spread on paste.

To the OP.

The jaw implants proposed to you elongate, 'drop down' the back border of the mandible and are used to address a short ramus. They are POROUS implants which allow for the surgeon to carve to desired shape and also INGROWTH of tissue to stabilize them over time which is a GOOD thing IF you like the outcome. But they become harder to remove (over time) due to tissue ingrowth. Also any implant can get infected over time. However, no one here can predict whether or not you will like them or not or decide to try a new shape later down the line.

That said, all I can tell you is the doctor proposed a type of IMPLANT to address your SHORT ramus and that it is NOT the paste substance that the others are referring to as the stuff that kicks up a lot inflammation.

[PloskoPlus]

NOTE:

The HA that causes a lot of the inflammation is the HA PASTE or HA granules; a substance that is mixed and spread onto an area. The OP in this string is NOT referring to that. He is referring to a jaw angle implant which can either be pre-fabricated or carved from a BLOCK of HA. In fact HA paste cannot be used to ELONGATE the ramus. Only a JAW IMPLANT can do that. So the OP is clearly not referring to the stuff that kicks up a lot of inflammation which is the spread on paste.

To the OP.

The jaw implants proposed to you elongate, 'drop down' the back border of the mandible and are used to address a short ramus. They are POROUS implants which allow for the surgeon to carve to desired shape and also INGROWTH of tissue to stabilize them over time which is a GOOD thing IF you like the outcome. But they become harder to remove (over time) due to tissue ingrowth. Also any implant can get infected over time. However, no one here can predict whether or not you will like them or not or decide to try a new shape later down the line.

That said, all I can tell you is the doctor proposed a type of IMPLANT to address your SHORT ramus and that it is NOT the paste substance that the others are referring to as the stuff that kicks up a lot inflammation.

I'm pretty sure it's just HA paste.  AFAIK, those fancy custom HA implants are vapourware.

[kavan]

I'm pretty sure it's just HA paste.  AFAIK, those fancy custom HA implants are vapourware.

Na..HA paste has to be overlayed onto a bone surface. It can't be used to vertically elongate the inferior border of the mandible. So the OP was offered an implant basically in the shape of an elbow bracket to 'drop down' the posterior border of the mandible (the ramus). An 'off the shelf' HA jaw implant can be custom carved by the surgeon.

[PloskoPlus]

Na..HA paste has to be overlayed onto a bone surface. It can't be used to vertically elongate the inferior border of the mandible. So the OP was offered an implant basically in the shape of an elbow bracket to 'drop down' the posterior border of the mandible (the ramus). An 'off the shelf' HA jaw implant can be custom carved by the surgeon.

Interesting... Do you have a link?

[kavan]

Interesting... Do you have a link?

No link on hand. But I know the difference between an HA block and/or a JAW IMPLANT made from an HA block vs a type of 'goop' (HA paste or HA granules) that is spread over the surface of the bone. The OP was clearly referring to an 'elbow shape' and an HA BLOCK and not the stuff that is spread onto the bone surface that is associated with a lot of inflammation.

HA can come in a BLOCK that can be carved. HA can come in the form of a ready made implant. HA can come in the form of PARTICULATE MATTER (granules) that can be mixed up as a paste like substance to spread over the bone. HA particles can also be found in filler material (like Radiesse) used as soft tissue filler where the aim of it is for the particles to kick up inflammation to surround the particles which, in turn, kicks up the soft tissue augmentation ('favorable fibrosis).

Gunson uses HA granules which he mixes with some substance in the blood and uses it to overlay onto an area. That stuff kicks up a lot of inflammation. Also, HA BLOCKS (to be carved) are used in LARGE CCW down grafts or any significant downgraft.