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.
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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. The man feels very happy for the surgery outcome and the entire surgery was done intra orally avoiding external scar formation.
4 months follow-up
4 months postoperative digital OPG and 3DCT shows good bone formation. Dental implants fixed in the newly formed bone with good stability and retention.

​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 man reported to our hospital seeking to correct his long lower jaw. This gave him an aged appearance and he was not happy with his facial profile.
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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 ramus region, excess bone was removed and the segment 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 lower jaw bone correction done without any scars on the face. His profile also improved dramatically giving him a renewed confidence.

A 55 year old patient reported to our hospital with a large, bony swelling in the anterior portion of the lower jaw (mandible). He had said that the swelling had gradually increased in size over the past 1 year and there was spontaneous loss of few lower teeth over the last 6 months. He also reported of altered sensation in the lower lip for past 3 weeks which was his main concern.
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 A 3D CT scan was taken to gauge the extent of the lesion. A biopsy was done which showed the lesion to be a multiple cystic ameloblastoma (tumor) of the lower jaw. Maxillofacial Surgeon Dr. S. M. Balaji removed the entire bony tumor along with the involved bone and reconstructed the defective portion of mandible using the native bone itself without any bone graft by following advanced transport guided distraction osteogenesis technique.

The entire affected portion of the lower jaw was ressected with 1.5 cm marginal clearance followed by reconstruction using titanium plate guided bilateral tripod multi docking complex univector Herford plate guided mandibular transport distractor.

After 5 days of latency period, the distractors were activated at a rate of 0.5mm twice per day (on both sides) until the transport discs had reached the canine region on both sides (amount of distraction on the right side was 46mm and on the left 43.2mm). Following consolidation period of 3 months and radiological evidence of corticalization, the distractors were removed. And complete dental implant rehabilitation done for lower arch in the newly formed healthy bone. Cosmetically well blended fixed ceramic prosthesis given.

An 18 year old girl from Bangladesh was brought to our hospital by her parents for expert treatment for her lower jaw defect. The girl complained of a intermittent pain and swelling in the left side of her lower jaw. The swelling was initially small and gradually increased to its present size for a period of 3 months. The parents were very worried about their daughter’s health.
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 premolar to second molar teeth involving impacted third molar. Almost entire bone in this portion of the lower jaw was lost. A biopsy of the lesion proved to be odontogenic keratocyst.
Dr. Balaji successfully removed the cyst completely along with the affected bone and teeth. 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.

A 32 year old man from Trichy came to our hospital for expert treatment for his lower jaw defect. He complained of an intermittent pain and swelling in the right side of his lower jaw. The swelling was initially small and gradually increased to its present size for a period of 3 months.
Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed a large radiolucent lesion involving impacted third molar. Almost entire bone in this portion of the lower jaw was lost. A biopsy of the lesion proved to be keratocyst due to impacted third molar.
Dr. Balaji successfully enucleated the cyst removing the cyst lining completely along with the affected teeth. Inferior border of the mandible and condyle preserved for continuity, graft contoured in L shape with titanium screws and inserted into the surgical site. Graft near the body of the mandible fixed with titanium plates & the surgical site was closed.

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.