Susie's Story


December 2020

Her body and face are wrapped in surgical blue fabric, leaving only her mouth exposed.

The car crash that smashed Susie Robinson’s jaw three decades ago has finally landed her here. On this operating table.

The surgeon is preparing for his experimental procedure for what is believed to be only the sixth time.

If all goes to plan, he says this technique might revolutionise dental implants and offer the hope of an intact smile for those with severely damaged jaws.

There’s still years of work to do establishing the benefits of this operation but Ms Robinson doesn’t mind.

She was the driver that night back in 1989, an inexperienced 20-year-old behind the wheel of an unfamiliar utility vehicle with three passengers, navigating winding country roads towards a party in Albury, three hours from home.

A policeman later told her she’d over-corrected on a bend and smashed into a tree. Nobody should have survived.

Most of those in the car were left with scars they would carry through life.

For Ms Robinson it was damage to her mouth. Her jaw was fractured in three places, requiring 30 pins along the gum and wiring from top to bottom to hold it in place.

Three teeth were knocked out of her top jaw and she later lost a fourth.

Over the next 28 years, she would spend more than $80,000 and undergo at least 15 operations to try to correct the damage.

“Having physical scars, and not just scars that you can see but internal, it does have an impact on how much you think you can take on, or how resilient you are.

“It does chip away a little bit at your self-confidence.”

Susie Robinson about four months after the accident with her jaw wired together.

The injury has been a constant reminder of her role in changing the lives of four families.

Two of her passengers had both legs broken in the crash, one also had a punctured lung, while the other – a promising athlete – was left with an ankle shattered so badly that doctors had to knit the veins back together.

“I changed the future of friends and my own and I know that accidents happen but you can’t get away from that, you have to take responsibility for that,” she said.

Last year, Ms Robinson was back where she started.

The dental implants that held her fake teeth in place for 15 years had cracked and needed to be replaced.

To do this using conventional techniques, doctors would first have operated to harvest bone from her hip and used this to build up the missing jaw.

Up to six months later, they would have then screwed the dental implants into the bone. It would have been another few months before she’d have teeth again.

Even then, it would not have been a sure thing. The past surgeries had chipped away at the bone and created a web of scar tissue.

But Ms Robinson won’t have to go through this arduous process because, in September 2016, she met Dr George Dimitroulis.

The oral and maxillofacial surgeon was trialling his own invention on patients at the Epworth Freemasons in East Melbourne.

He was using new technology and an old idea – a metal frame to do the work of the missing jaw and anchor false teeth.

They’re called subperiosteal frames and they fell out of favour in the early 90s because the technology did not yet exist to custom fit them to an individual jaw, explains Associate Professor John Cosson, the president of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons.

They were cumbersome, expensive and required multiple surgeries. Not now though.

Dr Dimitroulis is using titanium frames that can be 3D-printed to perfectly match each patient’s jaw.

Microscrews are used to hold the frame in place until the bone can grow around it and false teeth screw straight onto the frame’s prongs. Instead of two or three surgeries, this needs just one.

It has been about 16 months since the first patient was fitted with Dr Dimitroulis’ “Osseoframe”.

The greatest hurdle faced so far has been the gum peeling away, revealing the metal frame beneath.

Adjustments have been made with each patient, more and larger holes have been made in the frame to allow for better blood flow.

Dr Dimitroulis will present it to dentists and surgeons for the first time at the International Conference on Oral and Maxillofacial surgery in Hong Kong this weekend.

“The dental and medical professions are quite conservative and when you bring in a new technology that threatens existing practices they put up a wall,” he says.

“My biggest challenge is convincing surgeons and dentists that this is not a one-off 3D-printed gimmick for some rare disorder but in fact it’s something that may well be a game-changer as far as dental implants are concerned.”

Associate Professor Cosson said 3D-printed titanium was already being used to repair eye sockets and defects in the skull and cheekbones.

If using this approach to jaw defects proved successful, “it could make otherwise hopeless cases possible,” he said.

“The treatments provided should be considered ‘experimental’ at this stage and it will be essential to gather data for further study.

“I hope it works.”

The surgery had taken about an hour. Dr Dimitroulis cut around extensive scar tissue to lift what was left of Ms Robinson’s gum from the bone.

The frame was then secured with tiny screws before prosthodontist Simon Watson moved in to fit the teeth.

Susie and George Dimitroulis.


Five days later, Ms Robinson is smiling without the fear that something is going to fall out.

“It feels like I’ve forgotten to put my denture in,” she says with a grin.