Balaji Dental and Craniofacial Hospital - Dr. S.M Balaji, Maxillofacial Surgeron, India - Best Dental Clinic in Chennai : Best Dental Implant Center in India

Miracle protein rhBMP-2, bone graft and implants placed to replace missing teeth in deficient jaw bone

30/9/2014

A 45-year-old man from Australia came to our hospital seeking fixed replacement of his multiple missing teeth. The loss of many teeth over a long time led to progressive shrinkage of the jaw bone. The height of bone in the lower jaw was inadequate to place implants. Doctors elsewhere advised only removable dentures but the patient wanted fixed teeth to be able to chew and speak comfortably without the fear of dentures slipping off.

Maxillofacial Surgeon & Implantologist Dr. S.M. Balaji successfully reconstructed the deficient jaw using rhBMP-2 and bone graft to enable placement of implants and fixed teeth. The broken upper front teeth were extracted and immediate implants were placed in the same sockets without any bone loss. Implants were also placed in the right upper jaw. Implants and rhBMP-2 protein were placed in the lower jaw. This miracle protein stimulates the body’s own cells to form new bone thereby augmenting the jaw.

A costochondral rib graft was harvested & used to reconstruct the deficient height of the lower jaw and implants were placed. Subsequently, ceramic crowns closely resembling natural teeth will be fixed to the implants to complete the rehabilitation. The patient was very happy that he will have fixed teeth that will help him chew foods easily & give him a beautiful smile.

Successful correction of incomplete cleft lip

30/9/2014

A one-and-half year old boy was brought to our hospital by his parents for surgical correction of his incomplete cleft lip defect that affected his appearance.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the surgical correction of cleft lip using modified Millard’s technique. Following suture removal 7 days after surgery, the boy’s appearance greatly improved with the cleft defect corrected with hardly any scar. The boy’s parents were very happy with the surgery outcome and that their boy’s appearance was enhanced.

Preoperative view showing incomplete cleft lip defect

Primary cleft lip defect repair done

Postoperative view following suture removal after 7 days of surgery with hardly any scars

Ameloblastoma of lower jaw excised using intraoral approach

30/9/2014

A 28 year old man from Cochin reported to our hospital with the complaints of swelling with pain in right side of his lower jaw for past 2 months. Radiologic examination showed a radiolucent lesion extending posteriorly from the mandibular right second molar involving the ramus. Histopathological investigations showed the lesion to be ameloblastoma.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed an intraoral excision of the infected portion of the jaw with a marginal mandibulectomy procedure. The surgical procedure done through the mouth avoided any scarring of the face. Following surgery, the patient recuperated well and was happy to have his ailment treated successfully.

Preoperative view showing swelling in right lower half of the face

Preoperative digital orthopantogram showing huge unilocular radiolucency extending till coronoid process on right side

Affected portion of the lower jaw was surgically removed with intraoral approach along with the involved tooth

The intraorally excised ameloblastoma with the instruments used

Immediately after removal of the lesion mucosal flap was sutured

Postoperative orthopantomograph following successful marginal mandibulectomy of the lesion

Reduction rhinoplasty & lip revision for improved aesthetics in cleft patient

29/9/2014

A 25-year-old man reported to our hospital seeking to correct his cleft nose defect and lip scar to improve his appearance. He was previously operated elsewhere for cleft lip and palate. He had an unsightly scar of the cleft lip repair. His nose appeared bulky and deviated. Also the large, unpleasant hump of the nose affected the facial profile making his face unattractive.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed reduction rhinoplasty to decrease the overall bulk of the nose and to correct septal deviation. The lower lateral nasal septal cartilages were removed. Medial and lateral osteotomy was done with dorsal hump reduction. Cleft lip scar revision was also done. Immediately following surgery the nose appeared more proportionate and sharp. The nose profile appeared smoother & reshaped. This along with the revised lip scar greatly enhanced the facial appearance. The man was very happy with the surgery outcome and to have a more pleasing appearance.

Preoperative view showing bulky nose with deviated nasal tip

Preoperative profile view showing typical parrot beak appearance

During procedure deviated portion of nasal septal cartilage was exposed

Deviated caudal portion of nasal septal cartilage was removed intranasally

Medial osteotomy done to reduce the nasal hump and bulkiness of dorsum of the nose

Immediate postoperative view showing reduced bulkiness with deviated nasal septal correction without any surgical marks

Postoperative view showing corrected nose profile giving pristine appearance for his face

Successful corrective jaw surgery and rehabilitation with implants for patient with complex facial fractures

25/9/2014

A 26-year-old man from Singapore reported to our hospital seeking to correct his bite and replace his missing upper front teeth. He gave a history of having met with a vehicular accident in which he had sustained complex, multiple fractures of the upper & lower jaw, cheek & eye bones and forehead. The fractures were treated elsewhere. Subsequently he developed an incorrect bite because the jaw fractures were not fixed in proper occlusion.

Maxillofacial Surgeon Dr. S.M. Balaji removed the bone plate from the lower jaw and successfully performed an Obwegeser sagittal split osteotomy realigning the lower jaw in accurate relation with the upper jaw to correct the bite. Dental implants were placed in the missing teeth region of the upper front jaw. Later ceramic crowns will be fixed to the implants to complete the dental rehabilitation.

Combined Sphincter pharyngoplasty for speech correction and rhBMP-2 surgery for reconstruction of alveolar cleft

24/9/2014

A 26-year-old man from Lucknow, with unilateral cleft lip and palate came to our hospital for expert cleft management. He was previously operated elsewhere for cleft lip and palate deformity. He had a nasal sounding speech and cleft in the alveolar bone (teeth-bearing jaw bone) in the right upper jaw.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined sphincter pharyngoplasty & rhBMP-2 surgery. Cleft individuals have hypernasality due to escape of air through the nose during speech. This is called velopharyngeal incompetence and is corrected by pharyngoplasty. Dr. Balaji created a dynamic sphincter by surgically rearranging the palatopharyngeus muscles. Due to the huge alveolar cleft in the right upper jaw, the right side of his nose appeared collapsed. Dr. Balaji employed the advanced rhBMP-2 technology to completely close the bone defect. This miracle protein stimulates the body’s own cells to form new bone at the site it’s placed ultimately healing the gap. This revolutionary technology avoids a second surgery for grafting bone from the rib or hip.

Preoperative view showing depressed nasal base in right side due to huge alveolar cleft defect

Intraoral view showing altered palatopharyngeal muscles attachment affecting speech

Palatopharyngeal muscle detached for its different position and approximated into correct position on left side

Palatopharyngeal muscle detached for its different position and approximated into correct position on right side

Huge alveolar cleft defect on right side was exposed surgically

Miracle protein rhBMP-2 was placed in the alveolar cleft defect region to induce new bone formation

The video shows the new dynamic velopharyngeal sphincter action and a positive suction test indicating successful correction of velopharyngeal incompetence.

Simultaneous nose & jaw correction and lip correction with Abbe flap in cleft child from Seychelles

23/9/2014

A 13-year-old boy from Seychelles, born with bilateral cleft lip and palate was brought to our hospital by his parents for expert cleft treatment. He was operated elsewhere for primary cleft lip and palate. He had a thin upper lip, broad flattened nose and protruding lower jaw for which he sought treatment.

Maxillofacial Surgeon Dr. S.M. Balaji performed the specialized Abbe flap technique to correct the upper lip. A flap of tissue was taken from the lower lip and used to reconstruct the upper lip with the base of the flap still attached to the lower lip. Once blood supply is established, the flap will be divided giving the upper lip a more natural, improved form.

Simultaneously, the broad nose and protruding lower jaw was reshaped to make them more proportionate and balanced. Protruding lower jaw was corrected by following bilateral sagittal split osteotomy (Obwegeser’s osteotomy) and excess bone obtained was used to augment the dorsum of the nose. Following surgery, the nose appeared sharp & defined with more proportionate jaw profile.

Cyst enucleated and residual bone defect reconstructed with bone graft

22/9/2014

A 35-year-old female reported to our hospital with a complaint of severe pain and swelling with respect to her upper front teeth. A digital x-ray revealed a large cystic lesion at the root apex of maxillary right central and lateral incisor with resorption of the roots.

Maxillofacial Surgeon Dr. S.M. Balaji accessed the cystic lesion raising a gingivomucoperiosteal flap and completely enucleated the cyst. The affected teeth were extracted. The removal of the lesion left a large bone defect. For complete closure of the defect and to enable implant placement in future, the defect size was measured, a bone graft of the same size was harvested from the mandibular symphysis and placed in the bone defect successfully closing it. After subsequent healing, implants & ceramic crowns will be placed for fixed replacement of lost teeth.

Simultaneous corrective jaw surgery and cosmetic nose correction without any scars

19/9/2014

A 30 year old man from USA reported to our hospital seeking correction of his facial appearance. He was not happy with his broad flattened nose and upper jaw prominence giving him more aged appearance. He wanted to have cosmetic correction of his nose and jaw without any surgical marks on his face.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected his nose and jaw simultaneously by following anterior maxillary excess removal along with subapical osteotomy for lower jaw and dorsal augmentation of the nose with costochondral graft via intraoral approach. Results were immediate. Patient was very happy to have an improved appearance and that his nose and jaw correction was done concurrently without any surgical marks on his face.

Preoperative view showing broad flattened nose

Preoperative profile view showing flattened nose with protruding upper jaw

Maxillary excess removal done and augmentation rhinoplasty using costochondral grafting performed

Postoperative view showing reduced size of the nose with maxillary prominence correction

Postoperative view showing corrected nose profile with proportionate upper and lower jaw

Enhanced aesthetics with successful scar revision

17/9/2014

A 36-year-old man was previously surgically treated for fracture of the lower jaw that he sustained in a road traffic accident. Following successful treatment, he reported to our hospital seeking a correction of the unsightly scar on his lower lip to enhance his appearance.

Maxillofacial Surgeon Dr. S.M. Balaji performed the scar revision surgery. Following suture removal, the lower lip appeared reshaped with a more natural form. The scar was negligible and the man was very happy that his facial appearance was greatly improved.

Preoperative view showing huge scar with significant discontinuity in the shape of the lower lip due to trauma

Immediately following the surgical correction of lip defect achieving the continuity of the shape of the lower lip

2 weeks postoperative view showing complete removal of scar with corrected lip defect

Primary cleft lip repair for a baby born with unilateral cleft lip and palate

15/9/2014

A 3-month-old baby boy born with unilateral cleft lip and palate was brought to our hospital by his parents for surgical correction of his birth deformity.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the primary cleft lip repair using modified Millard’s technique. Suture removal was done 7 days following surgery. After lip repair, the baby’s parents were very happy to see their baby’s improved more normal appearance. Subsequently, the parents will return for further cleft management for their baby.

Preoperative view showing unilateral cleft lip and palate

Immediate postoperative view after suture removal following seven days of surgery

Two weeks postoperative view following suture removal

Combined rhinoplasty and lip scar revision to enhance appearance for cleft patient

5/9/2014

A 25-year-old girl came to our hospital seeking to correct the defects in her nose and upper lip to enhance her appearance. She was born with unilateral cleft lip and palate for which she was operated in her childhood. Now her nose appeared collapsed & flattened and there was an irregular scar on her upper lip.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined augmentation rhinoplasty and lip revision to correct the defects and improve her appearance. A costochondral rib graft was harvested and used to reconstruct the nasal framework. Dorsum of nose was augmented and alar base reconstruction was done through weir incisions. With this the nose was reshaped to a sharper, pristine form. Upper lip scar revision was also done in the same surgery. Immediately following correction of the nose & lip defect, her appearance improved greatly and she was very pleased with the surgery outcome.

Preoperative view showing broad nose with unsightly scar on the upper lip due to cleft defect

Costochondral graft harvested to reconstruct the nasal framework

Harvested graft used to augment the dorsum of the nose

Immediate postoperative view showing reduced size of the nose with corrected alar base and secondary lip revision done with minimal surgical marks

Successful primary cleft lip repair

4/9/2014

A 3-month-old baby girl born with unilateral cleft lip and palate was brought to our hospital for specialized cleft surgery. Maxillofacial Surgeon Dr. S.M. Balaji performed the primary cleft lip repair using modified Millard’s technique. Following surgical repair of the cleft lip the baby’s appearance improved greatly and the parents were very happy with the surgery outcome. Photographs of the baby taken at 6 months and 2 & half years of age show almost negligible scar and enhanced appearance after successful cleft lip surgery.

3-month-old baby girl with unilateral cleft lip and palate

Improved appearance after primary cleft lip repair at 6 months of age

At 2 & half years of age- very negligible scar and improved aesthetics after lip repair

Successful profile enhancement giving pleasant appearance without any scars

3/9/2014

A 30 year old lady reported to our hospital with the complaint of inability to close her lips and protruding upper front teeth due to forwardly placed upper jaw. Because of her appearance she was very self conscious and not social. Her parents too feel bad regarding her appearance.

Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected her appearance with orthognathic surgery. Results are immediate and both the patient and her parents are happy. Her profile view also enhanced dramatically without any scars on her face.

Preoperative view showing protruding upper teeth & inability to close the lips due to disproportionately large upper jaw

Preoperative profile view showing severely protruding upper jaw affecting appearance

Postoperative view showing enhanced appearance after corrective surgery of upper jaw

Postoperative profile view showing enhanced appearance of the face without any scars

Successful cosmetic correction of nose without any scars

1/9/2014

A 25 year old lady reported to our hospital with the complaints of broad flattened nose. She was very particular to have the cosmetic nose correction without any scars.

Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected her nose by following reduction rhinoplasty technique. Intranasally lower lateral nasal septal cartilage was removed to reduce the bulky nose tip and lateral osteotomy was performed. Results are immediate and patient was happy to have pristine nose correction done without any surgical marks on her face.