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General Category => Functional Surgery Questions => Topic started by: Greenlit on May 31, 2023, 10:57:24 AM

Title: Downgrafting with HA block, stability after hardware removal
Post by: Greenlit on May 31, 2023, 10:57:24 AM
Hello everyone !

I posted here several years ago, and I went through with a DJS with posterior downgrafting of the maxilla. This cured my sleep apnea, and the aesthetic part is way better.
Unfortunately, I had issues with infections on a maxillary plate (including one severe at 8 months post-op, 3 months ago), and I ended up removing everything because of it.

Surgeon told me no "non union" and the maxilla is stable. I am sending him an email asking the same as you guys, but wanted additionnal opinions:
Are there risks with the HA block used for the downgraft of the maxilla of "moving" without the screws/plates ? Of it getting fragile ? I have nightmares about the maxilla falling down without the plates... lol
For now I'll stop doing contact sports.

Thanks for the help !
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: kavan on May 31, 2023, 06:34:10 PM
Many surgeons suggest removing the plates after union has established because they are no longer needed and risk infection. So, I think you will be OK.
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: Greenlit on June 01, 2023, 12:20:06 AM
Thanks for the reply Kavan. Do we have any data regarding the strenght of the union, compared to "bone on bone"  ?
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: kavan on June 01, 2023, 03:41:27 PM
Thanks for the reply Kavan. Do we have any data regarding the strenght of the union, compared to "bone on bone"  ?

You don't have 'bone on bone'. You have a graft. So question about 'data' in my possession about bone on bone is an extraneous fly in after providing the salient info. What I can say is that hydroxyappatite grafts, if those are used which is often the case if you have a significant downgraft made from a material other than your own bone,...those grafts are porous and the bone grows into them to stabilize the union which the doctor told you you had.
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: Greenlit on June 02, 2023, 12:29:43 AM
You don't have 'bone on bone'. You have a graft. So question about 'data' in my possession about bone on bone is an extraneous fly in after providing the salient info. What I can say is that hydroxyappatite grafts, if those are used which is often the case if you have a significant downgraft made from a material other than your own bone,...those grafts are porous and the bone grows into them to stabilize the union which the doctor told you you had.

My bad, I phrased the question the wrong way. I wonder about the strenght of "bone on bone" union VS "graft on bone" (my case). Imagine getting a car accident, or getting punched, or a ball in the face.... that's what I meant by data regarding the strenght.
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: kavan on June 02, 2023, 01:20:49 PM
My bad, I phrased the question the wrong way. I wonder about the strenght of "bone on bone" union VS "graft on bone" (my case). Imagine getting a car accident, or getting punched, or a ball in the face.... that's what I meant by data regarding the strenght.

I have addressed the MAIN concern expressed in the TITLE of your initial post.
Title: Re: Downgrafting with HA block, stability after hardware removal
Post by: Greenlit on June 02, 2023, 02:05:55 PM
Fair enough. Thanks