Wrap-around Mandible Bone Graft?

[breezeblox]

Is this possible?

My surgeon has recommended SARPE for OSA and says that the lower arch will be tipped bucally. I'd rather use the SARPE as an opportunity to get more prominent cheekbones and expand the palate beyond the reach of my current lower arch. This would require a wider or thicker mandible. If I got grafts all around the mandible, the new bone (or bone like material) will make room for the lower arch to be widened with braces.

I don't think regular implants will allow me to widen the my lower arch

[Lazlo]

Is this possible?

My surgeon has recommended SARPE for OSA and says that the lower arch will be tipped bucally. I'd rather use the SARPE as an opportunity to get more prominent cheekbones and expand the palate beyond the reach of my current lower arch. This would require a wider or thicker mandible. If I got grafts all around the mandible, the new bone (or bone like material) will make room for the lower arch to be widened with braces.

I don't think regular implants will allow me to widen the my lower arch

Nope

[beyondconfusedtbh]

Nope

+1

[kavan]

No because the TEETH of the lower arch would be the limiting factor as they would need to meet the teeth of the upper arch expansion via the SARPE.

Even IF you disregard the technical challenges of kicking up a 'wrap around' bone graft, it would be the SAME as a wrap around IMPLANT in terms of a shape aesthetic although different material.

That is the reason for the big fat NO.

[breezeblox]

No because the TEETH of the lower arch would be the limiting factor as they would need to meet the teeth of the upper arch expansion via the SARPE.

Even IF you disregard the technical challenges of kicking up a 'wrap around' bone graft, it would be the SAME as a wrap around IMPLANT in terms of a shape aesthetic although different material.

That is the reason for the big fat NO.

So in order to expand (widen) the lower arch with orthodontia, there needs to be enough room provided by the mandible. I'm not sure if a jaw implant will allow for teeth to be orthodontically expanded beyond the natural mandible's limit. A graft, however, will create new bone. This will provide real estate for teeth to be moved onto.

[kavan]

So in order to expand (widen) the lower arch with orthodontia, there needs to be enough room provided by the mandible. I'm not sure if a jaw implant will allow for teeth to be orthodontically expanded beyond the natural mandible's limit. A graft, however, will create new bone. This will provide real estate for teeth to be moved onto.

You got the answer to your original question.

[breezeblox]

You got the answer to your original question.

What about a graft that extended from the angle of the mandible to just before (or at) the canine on either side? Wouldn't just be like grafts for dental implants except for on the side of the mandible?


If grafts can't be added at the angle of the mandible, then a standard implant can be inserted there - but with grafts extending from the last molar to the canine, no?

[kavan]

What about a graft that extended from the angle of the mandible to just before (or at) the canine on either side? Wouldn't just be like grafts for dental implants except for on the side of the mandible?


If grafts can't be added at the angle of the mandible, then a standard implant can be inserted there - but with grafts extending from the last molar to the canine, no?

What about your understanding that grafts added around the mandible will NOT increase the arch of the lower teeth. PERIOD.

[PloskoPlus]

In general, the lower arch is not expanded.  In rare cases, when the arch is really bad (triangular shaped, missing teeth), the lower arch may be split down the middle and distracted.

http://www.neom-rb.com.br/arquivos/34.pdf

AFAIK, it puts a lot of pressure on condyles and is prone to relapse.

Another option is sub-apical osteotomy.

https://pocketdentistry.com/mandibular-subapical-osteotomies/

The risk to the teeth is very high and it's not very stable.

You'll have trouble finding a surgeon willing to do either. 

There is also wilcodontics...