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

Dentigerous cyst surgery – Bone Graft and Dental Implant Surgery

12/4/2020

Diagnosis and initial attempted resection of anterior cystic lesion

This middle aged lady first noticed the swelling on her anterior left mandible two years ago. This was followed by loosening of teeth in the region. A local dentist had obtained an x-ray and diagnosed this to be a cystic lesion with an impacted tooth. He had attempted removal of the cyst; however, this had not resolved but had got infected.

Referral to our hospital for surgical removal of infected dentigerous cyst

Dr SM Balaji, jaw reconstruction specialist, examined the patient and obtained a biopsy. Biopsy confirmed this to be a dentigerous cyst. He advised resection followed by reconstruction with rib grafts and rehabilitation with dental implants.

The patient consented and subsequently underwent successful jaw reconstruction with rib grafts. She was advised to return in three months following bony consolidation of rib grafts with alveolar bone.

Dental implant India

Dental implant India

Dental implant India

Dental implant surgery after complete consolidation of graft with alveolar bone

The patient returned for dental implant placement after three months. Four Nobel Biocare dental implants were placed in the well consolidated alveolar bone. The patient was then instructed to return in four months to allow for implant osseointegration with bone.

Upon returning after four months, a ceramic bridge was fabricated in our in-house dental laboratory for the patient. Her bridge was then cemented to the implants to complete her rehabilitation.

Patient expresses her happiness at the successful completion of her treatment process

The patient expressed her complete satisfaction at the overall treatment experience at our hospital. She thanked the surgical team for her successful rehabilitation before discharge from the hospital.

Surgery Video

Dentigerous cyst surgery – Bone Graft and Dental Implant Surgery #dentalimplants #bonegraft #dentigerouscyst #drsmbalaji pic.twitter.com/6brM4uVmW6
— Balaji Dental and Craniofacial Hospital (@balajidental) April 12, 2020

Complete smile makeover following successful jaw reconstruction & dental implants for African boy

28/5/2016

A young African boy from Nigeria suffering from Ectodermal Dysplasia was referred to our Hospital for expert care. He had multiple missing teeth & had previously undergone bone grafting elsewhere but the graft had already resorbed & failed.
Maxillofacial Surgeon and Dental Implantologist Prof. Dr. S.M. Balaji performed the complete jaw bone reconstruction using costochondral rib graft . Implants were placed to replace his missing teeth. Following osseointegration of the implants, cosmetically well blended fixed ceramic prosthesis was given enhancing the appearance.

Multiple missing teeth in a boy suffering from Ectodermal Dysplasia

Xray before surgery

Failed bone graft done elsewhere

Harvested rib graft fixed to upper jaw bone

Lower jaw bone strengthened with rib graft

X-ray taken just after jaw reconstruction & implant surgery

Following ceramic prosthesis fixation giving enhanced natural smile

Extremely thin jaw bones reconstructed and rehabilitated with implants & prosthesis

10/2/2016

A 25-year-old American came to our hospital seeking a fixed replacement for his missing teeth. He gave a history of having had multiple impacted teeth which were extracted before, elsewhere. Subsequently there was severe deficiency of bone in his upper & lower jaw due to which he was refused fixed teeth there.
A 3D CBCT scan taken revealed severely atrophied maxillary & mandibular bone. Maxillofacial Surgeon & Implantologist successfully performed the jaw bone reconstruction and dental implant replacement for his missing teeth in two stage procedure. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone.

After complete jaw reconstruction, dental implants were fixed in the reinforced regions of the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis was fixed. The man is very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improves his appearance.

Implants placed in the upper jaw following bone grafting

Implant fixed with good stability and retention into the reinforced bone

Implant fixed with good stability and retention

Implants in position with enhanced healing

After placement of implants in lower jaw showing good healing

After prosthesis fixed to implants in upper jaw

Ceramic prosthesis placed resembling natural teeth

Cosmetically well blended fixed ceramic prosthesis

Enhanced appearance following complete rehabilitation

Enhanced smile following implant prosthesis

Extremely thin jaw bones reconstructed and rehabilitated with implants & prosthesis

8/2/2016

A 25-year-old American came to our hospital seeking a fixed replacement for his missing teeth. He gave a history of having had multiple impacted teeth which were extracted before, elsewhere. Subsequently there was severe deficiency of bone in his upper & lower jaw due to which he was refused fixed teeth there.
A 3D CBCT scan taken revealed severely atrophied maxillary & mandibular bone. Maxillofacial Surgeon & Implantologist successfully performed the jaw bone reconstruction and dental implant replacement for his missing teeth in two stage procedure. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone.

After complete jaw reconstruction, dental implants were fixed in the reinforced regions of the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis was fixed. The man is very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improves his appearance.

Before treatment-multiple missing teeth & extremely inadequate bone

Before treatment-insufficient bone unsuitable for implants

3D CBCT showing severely deficient bone in upper and lower jaw

Rib graft harvested

Thin residual alveolar process in maxilla

Bone graft fixed to enhance the alveolar bone to receive implants

Implants fixed in the right upper back region of the jaw following bone grafting

Bone reinforced with graft and implants placed in lower jaw

Simultaneous upper jaw reconstruction with bone graft, implant fixation and reduction rhinoplasty

16/6/2015

A young man from the Middle East was referred to our hospital for fixed replacement of his multiple missing teeth (anodontia). Along with placing implants, the patient also wanted to correct his nose shape to improve his appearance. A 3D CT scan revealed extreme deficiency of bone in his upper and lower jaw insufficient for placement of implants. Maxillofacial Surgeon & Implantologist Dr. S.M. Balaji reconstructed the maxilla and mandible using bone graft taken from the rib region.

Dr. Balaji successfully placed implants with good retention and stability in the reconstructed jaws. His nose was very long, broad, crooked and misshapen giving him an unattractive appearance. Simultaneously reduction rhinoplasty was performed to correct the nose shape. Lateral osteotomy was done to correct the deviated septum. Lower lateral nasal cartilages were trimmed to improve the appearance of the nose giving it a more balanced form enhancing the appearance. The patient was very happy with the surgery outcome without any scar on the face.

3DCT scan view showing complete anodontia of both maxilla and mandible with thin alveolar process

Intraoral view showing completely edentulous maxilla and mandible

Preoperative digital orthopantamogram showing completely edentulous jaws with iildefined alveolar process in maxilla

Harvested rib graft used to augment the maxillary alveolar ridge

Dental implants fixed in the lower jaw and stabilized with rib graft for good retention

3DCT scan showing good uptake of bone graft and osseointegration of lower implants

Facial view showing long deviated nose

Good bone formation following bone grafting

Implants fixed with good stability and retention in the newly formed bone

Immediately after suturing the gingivomucoperiosteal flap

Removal of caudal portion of lateral nasal septal cartilage to corret the bulkiness in the tip of the nose

Septal deviation was corrected intranasally

Immediate postoperative view showing pristine nose without any visible surgical marks on the face

Pre and post operative nose views

Postoperative OPG showing dental implants fixed with good retention in reconstructed maxilla and mandible

Successful jaw reconstruction & dental implants

25/2/2015

A young man from Middle East Asia suffering from Ectodermal Dysplasia was referred to our Hospital for expert care. He had complete missing teeth (anodontia) from childhood. Due to this there was progressive loss of alveolar process. He had consulted many dental surgeon for the same but due to reduced width and height of the alveolar process they refused to give dental implant replacement for his missing teeth.

Maxillofacial Surgeon and Dental Implantologist Prof. S.M Balaji performed the complete jaw bone reconstruction using rib graft & rhBMP-2. Implants were placed to replace his missing teeth in mandible. Following osseointegration of the implants, ceramic prosthesis will be given. Due to very thin alveolar process in maxilla, costochondral rib graft and BMP placed to enhance new bone formation. Later dental implants with good retention and stability will be placed after one month.

Intraoral view showing completely edentulous maxilla and mandible

3DCT scan view showing complete anodontia of both maxilla and mandible with thin alveolar process

Costochondral rib graft harvested to reconstruct the receded portion of alveolar process

Dental implants fixed in the lower jaw and stabilized with rib graft for good retention

Harvested rib graft along with miracle protein rhBMP2 used to reconstruct the alveolar process

Immediately after suturing following complete reconstruction of maxilla and mandible

Postoperative digital orthopantomogram showing graft stabilization and good dental implant retention in mandible

Combined jaw correction & lip and nose defect correction with Abbe flap technique & rehabilitation with implants for bilateral cleft lip & palate

10/11/2014

A 19-year-old boy reported to our hospital seeking to correct his nose, lip and jaw defect and to replace his missing upper front teeth. He was previously operated for bilateral cleft lip and palate elsewhere where his entire premaxilla was removed. His upper lip was very thin in the middle, his lower jaw was severely protruding and his nose defect affected his facial profile giving an unpleasant appearance. Also because of his missing upper front teeth he was unable to bite and eat properly.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined jaw, lip and nose correction. An Obwegeser’s bilateral sagittal split osteotomy was done reshaping the lower jaw bone and bringing it into proper alignment with the upper jaw. Dental implants were placed in the upper jaw to replace the missing teeth. In the Abbe flap technique, a flap of tissue was taken from the lower lip, rotated across the mouth and sutured together with the thin upper lip with the base of the flap still attached to the lower lip to maintain blood supply. The flap was taken with hair follicles to ensure proper moustache growth. After 3 weeks the flap was divided giving the upper lip a normal form and function. Ceramic crowns were fixed to the implants. Following complete rehabilitation, his appearance and self-confidence improved greatly and he is very happy with the results.

Preoperative facial view showing defective cleft lip and nose due to bilateral cleft defect

Preoperative intraoral view showing incorrect bite due to removal of premaxilla leading to missing teeth in upper front region of jaw

Reconstructed columella and shape of the ala of the nose by Abbe flap technique

Immediate postoperative view showing corrected bite by following Obwegeser's bilateral sagittal split osteotomy in mandible and lip revision by Abbe flap

Postoperative image showing corrected bite and missing teeth replacement with dental implant prosthesis

Postoperative facial view showing corrected lips, nose and missing teeth replacement giving enhanced appearance

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.

Extremely thin jaw bones reconstructed and rehabilitated with implants & prosthesis

14/7/2014

A 25-year-old man from Seychelles came to our hospital seeking a fixed replacement for his missing teeth. He gave a history of having had multiple impacted teeth which were extracted in a dental clinic in his hometown. Subsequently there was severe deficiency of bone in his upper & lower jaw due to which he was refused fixed teeth there.

A 3D CBCT scan taken revealed severely atrophied maxillary & mandibular bone. Maxillofacial Surgeon & Implantologist successfully performed the jaw bone reconstruction. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone. rhBMP-2 was placed to stimulate new bone formation & dental implants were fixed in the missing teeth regions in the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis were fixed. The man was very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improved his appearance.