​30 year old women reported to our hospital with the complaints of swelling in right side lower half of the face. She also said that this swelling was there for a very long period with occasional numbness in the right side of the face.
After thorough clinical, radiological and histopathological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as odontogenic keratocyst (OKC) involving right body and ramus of the mandible. He planned to remove the entire lytic lesion and reconstruction of the affected portion of the mandible in the same surgery. Costochondral graft was obtained from the ribs to reconstruct the mandible. Through intraoral approach, after raising gingivomucoperiosteal flap extending distally, the entire lesion along with the affected portion of mandible was removed in toto. Harvested rib graft was used to reconstruct the defective region of mandible. Patient is very happy to have both removal of the entire lesion and reconstruction of the affected portion of mandible in the same surgery.

​A 28 year-old man came to our hospital with a complaint of pain in his lower jaw. A digital X-ray and 3DCT scan was taken revealed a large cystic lesion extending from canine to canine of the mandible with complete erosion of the labial plate.
 Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Reconstruction of the bone defect was done using bone graft obtained from the retromolar region.  Following surgery the wound healed well and the patient was happy to be cured of his ailment.

A 26 year-old boy form West Bengal came to our hospital with a complaint of swelling with occasional pain in his upper jaw. A digital X-ray took revealed a large cystic lesion extending anterior teeth to premolar of the maxilla with complete erosion of the labial plate.
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Histopathological examination of the specimen showed it to be a huge infected dental cyst due to continuous trauma from occlusion resulting from anterior deep bite. Maxillofacial surgeon Dr. S. M. Balaji successfully removed the entire cystic lesion along with the lining in toto. Followed by defective region of the upper jaw was reconstructed using costochondral rib graft. Following surgery the wound healed well and the patient was happy to be cured of his ailment. After complete bone formation, fixed dental replacement of the missing teeth will be done using dental implants. 

​A 25-year-old woman reported to our hospital with a complaint of swelling with pain in her left side of lower jaw. A digital X-ray took revealed a large cystic lesion extending entire ramus and angle and part of the body of the mandible involving the molar teeth.
Histopathological examination of the specimen showed it to be a chronic infected dentigerous cyst. Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Following surgery the wound healed well and fixed molar teeth given using dental implants in the newly formed bone with good retention, patient was happy to be cured of her ailment and to have fixed teeth.

A 23 year-old boy came to our hospital with a complaint of swelling with pain in his lower jaw. A digital X-ray took revealed a large cystic lesion extending from anterior teeth to premolar of the mandible with complete erosion of the labial plate and impacted canine tooth.
 Histopathological examination of the specimen showed it to be a dentigerous cyst. Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Following surgery the wound healed well and the patient was happy to be cured of his ailment.

A 28 year old man from Nigeria came to our hospital for expert treatment for his lower jaw defect. He gave the history of surgical removal of cystic lesion which was histopathologically diagnosed as follicular cyst in his lower jaw twice in his hometown and reconstructed with Bio-oss synthetic bone protein. Recurrence of the cystic lesion noted and the swelling was initially small and gradually increased to its present size for a period of 5 months. He was worried for the recurrence and wants to have permanent solution for the same.
Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed a large radiolucent lesion extending from the lower left first molar teeth till right first premolar region. Almost entire bone in this portion of the lower jaw was lost.
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Dr. Balaji successfully removed the cyst completely along with the affected teeth and bone. Rib graft was harvested and the used to reconstruct the jaw bone defect & the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for fixed replacement of lost teeth.

A 30-year-old man from Bangladesh was suffering from severe pain and swelling in his right side of lower jaw. He also complained of difficulty to open his mouth wide and bite and chew foods. He was advised by his family doctor in his home town to go to Balaji Dental and Craniofacial Hospital at Chennai, India, for specialized treatment.
Maxillofacial Surgeon Dr. S.M. Balaji thoroughly evaluated his jaw defect clinically and using advanced 3D CT scan. The scan images showed that he had multiple and extensive areas of bone loss that appeared to resemble large cystic tumors involving the almost entire right side of lower jaw.
Biopsy of the lesion was done which proved it to be odontogenic keratocysts. Dr. Balaji planned a complete reconstruction of the lower jaw right side, using the man’s own rib graft. The affected portion of the lower jaw bone was surgically removed. Diseased portions of the bone were completely and thoroughly removed to ensure that there is no recurrence. A costochondral cartilage graft (rib graft) was taken and used to reconstruct the lower law. Following a few months time, rehabilitation will be completed with implants and ceramic prosthesis. The man feels very happy for the surgery outcome and the entire surgery was done intraorally avoiding external scar formation.   

A 14-year-old boy from Bangladesh was suffering from severe pain in his lower teeth and lower jaw. He also complained of difficulty to bite and chew foods. His parents, both doctors, were advised by their family doctor in their home town to go to Balaji Dental and Craniofacial Hospital at Chennai, India, for specialized treatment for their son.
Maxillofacial Surgeon Dr. S.M. Balaji thoroughly evaluated his jaw defect clinically and using advanced 3D CT scan. The scan images showed that he had multiple and extensive areas of bone loss that appeared to resemble large cystic tumors involving the almost entire lower jaw. Few teeth were missing and there were several supernumerary teeth embedded inside the jaw bone.
Biopsy of the lesion was done which proved it to be odontogenic keratocysts. Dr. Balaji planned a complete lower jaw reconstruction using the boy’s own rib graft. The affected portions of the lower jaw bone on both sides were surgically removed. Diseased portions of the bone were completely and thoroughly removed to ensure that there is no recurrence. A costochondral cartilage graft (rib graft) was taken and used to reconstruct the entire lower law. Following a few months time, rehabilitation will be completed with implants and ceramic prosthesis.
The boy and his parents are very happy with the surgery outcome.  The Hon’ble Former Chief Justice of Madras High Court and Judge Supreme Court of India His Excellency H L Gokhale and his wife visited the hospital and greeted the boy and his parents. Chief Justice expressed his wishes and fed the boy a piece of cake. He also commended Dr. Balaji on his remarkable expertise and applauded his excellence and outstanding achievements in successfully performing many such complex and rare reconstructive surgeries.