Coceancig bone graft for cheekbones following LeFort 1 advancement

[ZippyDrummer]

After large LeFort 1 advancements, it is sometimes necessary to enhance cheekbones which will often appear to be lagging behind. But this is obvious.

Dr. Paul Coceancig often remedies this cheekbone-to-jaw discrepancy via the use of Peek implants as shown below, ramus implants are also present because Dr. Coceancig does not distract the ramus (oral maxillofacial surgeons almost never distract the ramus).




Dr. Coceacig just posted a video about how this may also be done via the use of bone grafts.




My questions are:

How are bone grafts even able to produce predictable results? Like, with an implant, you know exactly what you're getting, you know the exact size, shape, lateral projection, anterior projection, etc. The bone graft is initially just a liquid, how does he even know where it's going to go? Or where it's going to settle?

Are there any advantages of bone grafts when compared to implants??

 

[crosshold]

terrible implant design and yeah bone paste is not predictable. just go with PEEK implants but custom designed by someone who knows what theyre doing

 

[twilight]

terrible implant design and yeah bone paste is not predictable. just go with PEEK implants but custom designed by someone who knows what theyre doing

how to tell if a implant design is bad? i cant tell for shit

 

[crosshold]

how to tell if a implant design is bad? i cant tell for shit

well for the jaw primarily

the mid mandible doesnt line up properly implant and the jaw angle goes too far up which is likely to cause a bloated look

a good jaw implant needs to be kept as close to the border of the mandible as possible to reduce the bloating effect and it should also be angular

 

[ZippyDrummer]

well for the jaw primarily

the mid mandible doesnt line up properly implant and the jaw angle goes too far up which is likely to cause a bloated look

a good jaw implant needs to be kept as close to the border of the mandible as possible to reduce the bloating effect and it should also be angular

View attachment 2039190

The implant is being demonstrated on an undistracted jaw, Dr. Coceancig typically places these implants post-distraction on Jaws that look like this (without the gap):

 

[ZippyDrummer]

terrible implant design and yeah bone paste is not predictable. just go with PEEK implants but custom designed by someone who knows what theyre doing

I can't find any of Coceancig's post-bone-graft results, maybe they look good? I dunno

 

[RealSurgerymax]

Onlay bone grafts resorb. Yaremchuk proved this a long time ago, it was one of his main research interests when he was younger.