​A young man came to our hospital seeking corrective jaw surgery to enhance his appearance. His lower jaw was excessively protruding causing an incorrect teeth occlusion that caused difficulties in biting and chewing. Additionally his chin bone was deviated away from the midline giving his face an asymmetric, crooked appearance.
Maxillofacial surgeon Dr. S.M. Balaji planned to correct the jaw defect with a combined bilateral Obwegeser’s sagittal split osteotomy and genioplasty. The mandible was set back to correct the alignment and bite using bilateral Obwegeser’s sagittal split osteotomy. With genioplasty, the deviated chin bone was corrected. The procedure was done from inside the mouth so there were no scars. Immediately after this corrective jaw surgery, the man’s appearance was greatly improved and he is very happy with the enhanced aesthetics.

A young man had met with a motor vehicular accident a few days in which he had sustained injuries to his lower jaw. He had severe jaw pain, his teeth occlusion was completely deranged and he had great difficulty in biting, chewing, swallowing and speaking.
A preoperative 3D CT scan revealed fracture in the right mandibular parasymphysis region and left angle of mandible. Maxillofacial Surgeon Dr. S.M. Balaji successfully fixed and stabilized the fractured segments using bone plates and screws. Accurate occlusion and bite was achieved.

A young man came to our hospital seeking corrective jaw surgery to enhance his appearance. His lower jaw was excessively protruding causing an incorrect teeth occlusion that caused difficulties in biting and chewing. Additionally his chin bone was deviated away from the midline giving his face an asymmetric, crooked appearance.
Maxillofacial surgeon Dr. S.M. Balaji planned to correct the jaw defect with a combined bilateral Obwegeser’s sagittal split osteotomy and genioplasty. The mandible was set back to correct the alignment and bite using bilateral Obwegeser’s sagittal split osteotomy. With genioplasty, the deviated chin bone was corrected. The procedure was done from inside the mouth so there were no scars. Immediately after this corrective jaw surgery, the man’s appearance was greatly improved and he is very happy with the enhanced aesthetics.

A 32-year-old man reported to our hospital seeking to correct his protruding upper jaw to enhance his appearance. His forwardly placed upper jaw and upper teeth made it difficult to close the mouth normally and he was very self-conscious of his looks.

Radiographic analysis of the facial bones showed that his maxilla (upper jaw) was disproportionately large compared to the lower jaw which caused the upper jaw and teeth to be very protruding. Maxillofacial surgeon Dr. S.M. Balaji performed the corrective jaw surgery or orthognathic surgery. The excess bone from the upper jaw was removed & the jaw was set back in proper alignment with the lower jaw. Immediately following surgery his appearance improved with the more balanced features. The procedure was done from within the mouth so there were no scars. The man was very happy with his new, improved look. 

A 30 year old lady from Saudi Arabia reported to our hospital with the complaints of missing teeth and more forwardly placed upper front teeth. She wanted to correct both the proclination and to replace the missing teeth with the dental implants in the same visit. She consulted various dental implantologists regarding her missing teeth replacement where they refused fixed replacements due to lack of bone support. 

Maxillofacial Surgeon and Implantologist Dr. S. M. Balaji successfully corrected both the proclination and replacement of her missing teeth in the same surgery. By following Le Fort I osteotomy the severely protruding upper jaw was set back to a more balanced occlusion. A sinus-lift procedure was done to enable implant placement in the decreased height region of the upper jaw. A “window” was cut & the lining of the maxillary sinus was lifted. The excess bone from the jaw correction was ingeniously packed in the space below the sinus membrane thereby increasing the width of jaw bone & implant was successfully placed. Later ceramic crowns will be fixed for complete dental rehabilitation. 

An 18-year-old girl from Bangalore was brought to our hospital by her parents for expert correction of her protruding upper jaw that caused an unattractive “gummy smile”. The girl was about to begin her college education and she was very self-conscious about her appearance.

Her facial bones were analyzed using digital x-rays. Her upper jaw or Maxilla was disproportionately larger as compared to the lower jaw and her upper lip was short causing too much of the gums to be visible while smiling. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the corrective jaw surgery or orthognathic surgery with Le Fort I osteotomy. The upper jaw was set back, reshaped & realigned in perfect facial harmony. The entire procedure was done from inside the mouth so there were no scars. Immediately following surgery the girl’s appearance was greatly enhanced and her more attractive, pleasing smile boosted her confidence.

A 15 year old boy with unilateral cleft lip and palate reported to our hospital with the complaints of asymmetrical nose and depressed nostril on the right side due to huge cleft defect. And he wants to correct his jaw alignment where the lower jaw is prognathic due to which he was not able to bite and chew any hard food stuffs. Defective nose profile reduced his self confidence considerably.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct his cleft nose defect as well as the jaw alignment simultaneously. Cleft nose defect was corrected with columellar strut graft harvested from the ribs, through intraoral approach and shape of the ala was maintained. Also alar base was raised with the graft.

Skeletal malocclusion correction was done by subapical osteotomy and thus skeletal cross bite was corrected. Patient and his parents were happy to have both the defective nose and bite correction done simultaneously without any scars on the face. Results are immediate. 

A 30 year old man from Oman came to our hospital with the complaints of severe pain and swelling in the right side of his lower jaw. A 3D CT scan & thorough histopathological examination revealed he had multilocular ameloblastoma in the right lower jaw.

Maxillofacial surgeon Dr. S.M. Balaji expertly planned the complete jaw reconstruction. The affected portion of the mandible (lower jaw) was surgically ressected. A rib graft was harvested & used to reconstruct the excised portion. Miracle protein rhBMP-2 was placed. This stimulates the body’s own cells to form new bone at the site thereby ensuring complete healing of the bone defect.

Few months following surgery, remarkable healing of the jaw bone defect was seen. Implants were placed in the missing teeth region of the lower jaw and ceramic prosthesis were fixed. The man was very happy that his jaw bone defect is cured completely and with the implants he is able to chew & eat well. 

A 25 year old man reported to our hospital seeking to correct his protruding lower jaw. This gave him an aged appearance and he was not happy with his facial profile.

Maxillofacial Surgeon Dr. S. M. Balaji expertly planned to correct his lower jaw protrusion by using bilateral sagittal split osteotomy technique (Obwegeser sagittal Split osteotomy). Intraorally a cut was made bilaterally in the lower jaw bone in the mandibular ramus region and the bone was set back to its correct position and thus correct dental occlusion was achieved. Results are immediate and the patient was happy to have his jaw bone correction done without any scars on the face. His profile also improved dramatically giving him a renewed confidence.

A 26-year-old girl reported to our hospital seeking expert correction of her cleft nose and jaw defect to enhance her facial profile. She was operated elsewhere in her childhood for cleft lip and cleft palate. Now her nose appeared collapsed on the left side and her protruding lower jaw deflected from a pleasing profile. 

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed a combined nose & jaw correction. A costochondral graft was harvested and used to reconstruct the collapsed portion of the nose. The procedure was done from inside the nose itself so that there are no scars. Mandibular shortening was done to make the lower jaw proportionate and to improve the facial profile. Immediately following surgery, her facial profile and appearance greatly improved and she was very happy to have a more attractive appearance without any scarring on the face. 

A 29-year-old man from Singapore reported to our hospital seeking expert treatment for his widely spaced upper right teeth due to which there was food impaction problem & caused an aesthetic concern. Also his upper right teeth were mobile which made it very difficult to bite & chew food. 

Digital X-ray taken showed bone loss in the region of upper right incisor, canine & first premolar that caused mobility of the teeth. Maxillofacial Surgeon Dr. S.M. Balaji performed the jaw bone reconstruction. The periodontally weakened teeth were extracted and implants placed. A symphysis bone graft was harvested from the lower jaw chin region & placed in the bone deficient region of the upper jaw to compensate the bone deficiency. The surgical site was sutured. Crown prosthesis will be given later to completely replace his missing teeth. 

A 20 year old girl reported to our hospital wanting to correct her gummy smile. Also her protruding lower jaw affected her appearance. She had low self-esteem & she wanted to enhance her looks. She had already consulted many dentists and had braces for 3 years elsewhere, but she was not satisfied with the results. Her parents too were anxious to correct her smile and enhance her facial appearance before getting her married.

Maxillofacial Surgeon Dr. S. M. Balaji expertly planned for simultaneous correction of her both upper and lower jaw. Surgical correction of gummy smile was done with Le Fort I osteotomy to reduce the maxillary excess bone. Protruding lower jaw was set back intra orally with sagittal split osteotomy. Post operatively her appearance improved greatly & instantly due to excellent profile correction. She & her parents were very happy with the immediate results & that the jaw correction surgery was done without any scars on the face. 

An 18 year old boy reported to our hospital with the complaints of severe pain and swelling in the left side of his face. Intraorally, a bone plate was exposed and huge infection with pus discharge adjacent to the exposed plate region was noticed.  He gave a history of odontogenic keratocyst (OKC) in the left side of the lower jaw which was removed elsewhere and reconstructed with bone graft and bone plate twice, 1 year back. His parents were frustrated due to repeated surgeries.

Maxillofacial Surgeon Dr. S. M. Balaji adroitly planned to remove the infected bone graft and plate and to reconstruct the lower jaw in a single surgery. He approached the surgical site extraorally through the previous scar region and removed the dislodged bone plate and sequestrum completely. Adjacent infected bone was removed with bone curette and a new NiTi bone plate was fixed to the adjacent healthy bone. To enhance the rigidity, costal graft was harvested and placed near to the bone plate with rhBMP-2 to increase the efficiency of new bone formation. Mucosal flaps were approximated in layers with very minimal scar formation. 

Post operative X-ray taken after 3 months revealed good amount of healthy bone formation maintaining the contour of the mandible using bone plate.

An 8 year old boy with bilateral cleft lip and palate defect from Mumbai was brought to our hospital with his parents for closure of the cleft defect in the teeth bearing region of upper jaw bone and further rehabilitation of his cleft deformity. The primary cleft lip and palate repair was done elsewhere.

The premaxilla was separated from rest of the alveolus which can be clearly appreciated in 3D CBCT scan. Thus upper alveolus was separated into three different parts which will severely affect the development of teeth later.

Maxillofacial Surgeon Dr. S. M. Balaji performed the premaxillary setback procedure with rhBMP-2 which helps in uniting the three parts into a single jaw bone with new bone formation. This surgery helped for proper growth and development as well as alignment of his teeth.

Sixteen years ago, a 4-month-old baby girl born with unilateral cleft lip & palate was brought to our hospital by her parents for the complete rehabilitation of her cleft deformity. Maxillofacial Surgeon Dr. S.M. Balaji performed the successive surgeries over the years.

Primary cleft lip repair surgery was done when the baby was 4 months old and palate repair surgery was done at 8 months of age. When the baby was 6 years old, rhBMP-2 surgery was done to treat the alveolar cleft defect. Miracle protein rhBMP-2 was placed in the cleft of the teeth bearing region of the upper jaw to completely heal the bony defect avoiding bone graft.

Now the girl reported to our hospital seeking to enhance her facial profile. She had a hypoplastic maxilla (retruded upper jaw) and she was not happy with her appearance. Dr. Balaji performed the intraoral maxillary distraction osteogenesis whereby the upper jaw was advanced and aligned properly with the lower jaw. This was done completely inside the mouth so there were no scars. Using distraction & orthodontics, her appearance & facial profile was greatly enhanced.  

A 35-year-old man reported to our hospital seeking expert treatment for his lower jaw (mandible) fracture. He gave a history of having sustained the injury in a road traffic accident. He had sought various treatments elsewhere but the multiple surgeries were futile with non-healing results. 

A CT scan showed complete non-union of the fractured segments. Maxillofacial Surgeon Prof. S.M. Balaji performed the surgery for jaw fracture fixation. The fracture site was accessed and fibrous tissue as a result of non-healing of the fractured fragments was removed. The bone ends were freshened, proper occlusion was established, and the fractured fragments of the lower jaw were fixed with a 6-hole & 4-hole bone plate with 2 mm screws. A cortico-cancellous bone graft from the right hip region was harvested and packed into the fracture defect. The graft and bone ends were covered with a collagen sponge soaked in rhBMP-2. rhBMP-2 is a miracle protein that stimulates the body’s own cells to form new bone thereby ensuring complete healing of the bone defect. Following this, the wound was sutured.