Blog - Balaji Dental and Craniofacial Hospital

February 7th, 2020 09:24 pm February 7, 2020

Thin upper lip correction – Cosmetic Lip Surgery

Patient born with cleft lip and palate deformity The patient is a 29-year-old patient from Theni in Tamil Nadu, India. He was born with a cleft lip, palate and alveolus deformity. His parents had been advised of the correct time schedule for surgical correction of his deformities. The birth had been uneventful and without any complications. As advised at the time of his birth, he had undergone cleft lip surgery at 3 months and cleft palate surgery at 9 months. Alveolar cleft surgery had been performed at 3-1/2 years. All surgeries had been performed elsewhere. He had subsequently developed acceptable feeding and speech patterns with acceptable esthetics. Increasing degree of facial deformity with the passage of time As he grew older, the degree of facial deformity gradually increased. He had been bullied a bit while in school and in college. The deformity had been bothering him a lot lately and he discussed this with his parents. They then decided to get it surgically corrected. He had made extensive enquiries and had been referred to our hospital by multiple sources. Our hospital is a specialty center for facial deformity surgery. Many patients who are dissatisfied with their appearance have undergone facial cosmetic surgery at our hospital. International recognition of our hospital by premier organisations We are a recognized referral center for the Japan-based International Cleft Lip and Palate Foundation (ICPF). The US-based World Craniofacial Foundation (WCF) has also named us as its affiliate in the Southeast Asian region. Initial presentation at our hospital for lip deformity surgery Dr SM Balaji, lip reconstruction surgeon, examined the patient and obtained a detailed history. The patient complained of a deformed upper lip and he felt that it was also very thin and asymmetrical. The patient also stated that speech and word formation was always difficult due to the lack of bulk in his upper lip. He desired to have a full upper lip that was in harmony with the rest of his face. Treatment planning formulated for correction of thin lip deformity A complete clinical and radiological evaluation was performed on the patient. It was decided to harvest a strip of fascia lata tissue from the patient’s thigh to augment the thin lip. The treatment planning was explained to the patient in detail. All his doubts regarding the surgical procedure were answered to his satisfaction. The patient then consented for surgery and was scheduled for reconstruction of his thin lip deformity. Successful surgical reconstruction of his thin upper lip Under general anesthesia, two linear vertical incisions were first placed over the lateral aspect of the right thigh. Dissection was then done up to the vastus lateralis muscle and the fascia lata was identified. A strip of fascia lata was then separated from the muscle and harvested. The incisions were then closed using sutures. Incisions were then made over the previous surgical scars in the upper lip. Tunneling was done up to the commissures of the upper lip bilaterally. The thin lip was then augmented using the fascia lata graft. The incisions were then sutured using nonresorbable sutures. Complete patient satisfaction with results of surgery There was excellent esthetic result from the lip reconstruction surgery. The degree of upper lip fullness from the surgery was in perfect harmony with the rest of his face. He said that he was very happy with the result of the surgery. His parents were also very happy with the result of the surgery. They mentioned that this will help him regain his self confidence. The patient also expressed complete satisfaction before final discharge from the hospital. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

February 2nd, 2020 03:33 pm February 2, 2020

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Closed Rhinoplasty – Nasal Deformity Correction Surgery

Broad nose deformity as chief complaint The patient had always felt that the bridge of his nose was depressed and that his nose was broad. The patient had been born with a left sided cleft lip and palate deformity. His parents had been advised of the right time schedule for him to undergo cleft lip and palate repair. He had subsequently undergone cleft lip and palate surgery in his home state of Kerala, India when he was three months and eight months old respectively. This had resulted in significant improvement in esthetics and function. He had been able to feed well and his BMI had always been within normal limits for age. However, children with this deformity tend to have exacerbation of the defect as they grow up. Facial morphology changes rapidly with growth and any residual bony defect from the cleft palate gets amplified. Depressed and lacking self confidence because of the nasal deformity He is now 24 years old and quite depressed about the appearance of his nose. The bridge of his nose was depressed leading to the nose appearing excessively broad for his face. The patient was worried that his nose was looking very big and ugly. The nose was also depressed on the left side. He has a typical cleft lip nasal deformity now. Because of the above factors, the patient desired to get his facial deformities corrected. He and his parents had made widespread enquiries regarding the best cleft rhinoplasty hospital in India. They had subsequently decided to come to our hospital for his nasal deformity surgery. Plastic surgeons and oral and maxillofacial surgeons perform cosmetic rhinoplasty. Initial presentation at our hospital for his corrective surgery Dr SM Balaji, cleft rhinoplasty surgeon, examined the patient. The left side of his nose was depressed because of his cleft lip and palate deformity. He explained the treatment plan to the patient and his parents. Nasal bridge augmentation would first be performed with a costochondral rib graft harvested from the patient. This would be followed by alar web correction surgery in the left nostril. Lateral osteotomy surgery would then be performed bilaterally resulting in correction of his broad nose deformity. The patient consented to the treatment plan. Surgical correction of the patient’s complaints Under general anesthesia, a right inframammary incision was made and a costochondral rib graft was harvested. The incision was then closed in layers with sutures. Attention was next turned to the nasal bridge augmentation surgery. An intercartilaginous incision was made in the left nostril. The lateral nasal cartilage was excised partially. Dissection was done up to the nasal bridge, which was augmented using the costochondral graft. Alar web correction surgery was then done in the left nostril. Bilateral lateral osteotomy was then performed following which closure was done intranasally using resorbable sutures. Total patient satisfaction at the results of the surgery The patient and his parents were very happy with the esthetic results of the surgery. He now had an elevated, more symmetrical, narrow, and prominent nose. This was in complete harmony with the rest of his facial features. He stated that his self confidence levels had soared up before final discharge from the hospital. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 29th, 2020 11:44 am January 29, 2020

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Wisdom Tooth Surgery – Mandibular Nerve Passing Through Tooth

Patient with pain and swelling in the posterior left mandible The patient is a 25-year-old female from Kumbakonam in Tamil Nadu, India. She had developed severe pain and swelling on the left side of her mandible. The patient had a grossly decayed left third molar. There was also severe trismus with limited mouth opening due to the presence of the infected tooth. Inferior alveolar nerve passing through impacted mandibular molar The patient had presented at a nearby dental clinic for management of her problem. An OPG had been obtained, which revealed bilaterally impacted mandibular third molars. The left third molar was grossly infected. The right third molar was completely submerged within bone and the inferior alveolar nerve was passing through the tooth. Upon viewing this, the doctor had realized that this was a complicated extraction that needed to be performed by an experienced oral and maxillofacial surgeon. He had subsequently referred the patient to our hospital for extraction of her impacted mandibular molars. Our hospital is a specialty center for complicated extractions. Molar impactions present at the lower border of the mandible are addressed here. Simultaneous extractions of bilaterally impacted maxillary and mandibular molars are routinely operated in our hospital. International acclaim from world renowned organizations Our hospital is also renowned for complex craniofacial surgery in India along with facial trauma surgery and facial cosmetic surgery. It has been widely decorated by many acclaimed international organizations. They include the World Craniofacial Foundation founded by Prof Kenneth Salyer and the International Cleft Lip and Palate Foundation founded by Prof Nagato Natsume. Initial presentation at our hospital for management of her problem Dr SM Balaji, jaw reconstruction surgeon, examined the patient and obtained a detail history. He also ordered 3D CT scan and other pertinent imaging studies. The patient stated that she had severe pain and swelling in left mandibular molar region for one week. The 3D CT scan revealed bilaterally impacted lower third molars. The left molar was grossly decayed. The inferior alveolar nerve which provides sensation to the lower lip was passing through the root of the impacted right third molar. Treatment planning was explained in detail to the patient and her parents. The importance of preventing any injury to the inferior alveolar nerve was explained in detail to them. They were in agreement with the treatment plan and consented to surgery under general anesthesia. Successful surgical removal of the third molar teeth Under adequate general anesthesia, atraumatic extraction of the maxillary third molars were done. Modified Ward’s incision was utilized for extraction of the lower third molars. A flap was first raised on the left side and bone was reduced around the carious third molar tooth. This was followed by transalveolar extraction of the grossly decayed tooth. Bone was reduced to expose the submerged right third molar tooth. The tooth was then sectioned taking great care to ensure there was no damage to the inferior alveolar nerve. The sectioned parts of the tooth were then carefully extracted to prevent any damage to the nerve. The flap was then sutured using resorbable sutures. Complete patient satisfaction with resolution of pain and swelling Nerve function tests were performed and all nerve functions were fully intact. The patient was very happy that a potentially complicated problem had been solved with such ease. She did not experience any numbness and had no postoperative complications following the removal of her third molars. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 27th, 2020 09:16 pm January 27, 2020

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Comminuted Zygoma Fracture – Medpor Orbital Blowout Repair

Patient involved in an accident while on a holiday The patient is a 28-year-old male from Chennai, Tamil Nadu, India. He was recently holidaying with his family in Rajasthan when he was involved in a motor vehicle accident. A camel had suddenly strayed onto the path of his car, which had resulted in a collision. His face had violently impacted on the steering wheel causing fractures (broken bones) to his orbit and zygomatic bone. Emergency treatment at a nearby city hospital He did not lose consciousness following the injury; however, there was significant double vision. The patient was rushed by his family to a nearby hospital where his right upper eyelid soft tissue laceration was sutured. Imaging studies were also obtained, which revealed fractures to the right side of the face. He was advised surgery, but declined as he wished to undergo surgery at our hospital. Our hospital is renowned for facial trauma surgery arising from road accidents. The facial cosmetic surgery services available at our hospital provide very good esthetic outcome for the patient. We have a dedicated facial trauma care unit that caters to such cases. Patient presents to our hospital for surgical management of fracture Dr SM Balaji, facial trauma surgeon, examined the patient and obtained a detailed history. He then ordered a 3D CT scan and other pertinent imaging studies. The patient complained of a depression on the right side of the face and double vision in the right eye. Clinical examination revealed depressed right zygoma and double vision. Radiographic examination revealed a shattered zygoma and orbital floor with a midpalatine suture split. There was evidence of subconjunctival hemorrhage in the right eye as a result of the trauma. The patient was experiencing severe discomfort and difficulty with viewing due to his double vision. Treatment planning presented to the patient in detail It was explained to the patient that he needed fixation of the midpalatine suture split. He also needed lateral orbital wall fracture fixation and right orbital floor reconstruction with a titanium Medpor implant. Zygoma fracture elevation and fixation would be performed through an intraoral approach to avoid external scar formation. It was also explained that he needed to stay on a liquid diet for about one to two weeks following surgery. The patient and his parents were in complete agreement with this surgical plan and consented for surgery. Presurgical anesthetic evaluation was completely normal for the patient. This was performed per American Board certified presurgical protocols. Successful surgical reduction of multiple facial fractures Under general anesthesia, a sulcular incision was made in the left anterior maxilla and mucoperiosteal flap raised. The dentoalveolar fracture and midpalatine suture split was reduced and fixed using titanium plates and screws. This was followed by a vestibular incision that was made in the right posterior maxilla. A flap was raised and the fractured segments of the zygoma were visualized. Eye lid surgery followed with placement of a lateral canthal incision. The lateral orbital wall fracture was then reduced and fixed using titanium plate and screws. Following this, the comminuted right zygoma fracture segment was reduced, elevated and fixed using titanium plates and screws. A transconjunctival incision was then made and the inferior orbital wall fracture was visualized. Orbital contents were elevated. Herniated periorbita was released from the orbital floor. The floor of the orbit fracture was then reconstructed using a Titan Medpor implant. Closure of incisions was done using resorbable sutures intraorally and non resorbable sutures extraorally. Total patient satisfaction following surgery Surgery was successful with no complications. Results were immediate with restoration of previous facial esthetics. The patient and his family were fully satisfied with the outcome of the surgery. There was no depression and his face was now symmetrical on both sides. His double vision was also corrected following orbital floor reconstruction. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 26th, 2020 04:03 pm January 26, 2020

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Cleft Rhinoplasty, Lip Revision Surgery, Columella Correction

Patient with asymmetrical nose and prominent lip scar The patient is a 22-year-old male from Kasargod in Kerala, India. He had been born with a cleft lip, palate and alveolus deformity. Surgical repair of his deformities had been performed at the correct prescribed times at a local hospital. The patient had subsequently developed normally with good speech and nutrition. However, there had always been residual facial and nasal deformity from the surgery. This had led to a degree of bullying during his schooling. As the patient grew older, the amount of nasal deformity had gradually increased. Nasal deformities usually involve both bone and cartilage. There was also some hypertrophic scarring at the site of the lip correction. About two years ago, the patient and his parents had visited a nearby city for consultation regarding corrective surgery. This is one of the treatments that would be addressed by a cosmetic surgeon in India. Facial plastic surgery will correct this esthetic shortcoming. Initial presentation for facial deformity correction surgery Upon viewing the patient’s deformity, the surgeon had recommended rhinoplasty with costochondral graft placement. The patient and his parents consented and surgery was performed; however, they were highly dissatisfied with the results of the surgery. The lip scarring had worsened and he had also developed breathing problems after the surgery. His breathing problems worsened considerably to the point where they visited a cosmetic surgeon in their hometown. After examining the patient, the surgeon realized that he needed to be operated at a specialty center. He had therefore referred him to our hospital for correction of his complaints. Our hospital is a specialty center for facial cosmetic surgery in India. We are also a reputed center for cosmetic rhinoplasty, cleft rhinoplasty, jaw reconstruction surgery and facial trauma surgery. Our hospital is a world renowned center for craniofacial surgery. Scores of children with craniofacial deformities have been rehabilitated in our hospital over the years and now lead normal lives. Initial presentation at our hospital for corrective surgery Dr SM Balaji, Cleft Rhinoplasty Surgeon, examined the patient and obtained a detail history. The patient complained of a depressed nose. He also said that he had developed breathing difficulties after his first surgery. The patient stated that the scar on his lip had also worsened after the previous surgery. He said that he desired to surgically have his nose and lip scar addressed. Treatment planning was explained in detail to the family. This would first involve harvesting a costochondral graft from the patient. This would be followed by lip scar revision with correction of vermillion notching and rhinoplasty correction. A strut graft would be used to correct the columellar deformity. The patient and his parents were in complete agreement with the treatment plan and consented to surgery. Various nasal shapes and deformities of the nose Shape of the nose varies widely due to differences in the shape of the nasal bone. This gives rise to the shape of the bridge of the nose. Nasal form was first classified by Eden Warwick in 1848. Nasal deformities include broad, narrow, crooked, saddle nose etc. Some birth defects such as Down’s syndrome manifest a small nose with a flattened nasal bridge. This can be due to the absence of one or both nasal bones, shortened nasal bones or unfused bones in the midline. Successful surgical correction of facial deformities Under general anesthesia, the previous surgical scar in the right inframammary region was excised. A costochondral graft was then harvested. The lip scar was excised and lip revision was done. The notching on the vermillion was also corrected. This was followed by a transcartilagenous incision to the right and left nostril. A strut graft was placed to elevate the columella. Closure of the incision was done intranasally using resorbable sutures. Total patient satisfaction at the results of the surgery The patient and his parents were very pleased with the surgery. He now had a symmetrical and prominent nose. There was also establishment of a perfect Cupid’s bow lip form. He said that he could now face social situations with complete confidence. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 25th, 2020 04:08 pm January 25, 2020

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Ectopic Eruption – Maxillary Sinus Impaction surgery

Patient develops discomfort and heaviness in right side of face The patient is a 24-year-old male from Chennai in Tamil Nadu, India. He had developed a mild pain and a slight swelling in the right side of his upper jaw. This has been ongoing for the last 7-10 days. He has a history of sinusitis for the past few years. The swelling had become noticeable and he had made enquiries regarding the best hospital to get this treated. He had been referred to our hospital by his family doctor. Initial examination at our hospital Dr SM Balaji, Oral and Maxillofacial Surgeon, examined the patient and obtained a detailed history. A 3D CT scan was obtained to fully visualize the maxillary sinus. This revealed that the sinus was filled with exudate. There was also an impacted third molar, which was found embedded in the floor of the orbit within the sinus cavity. This was diagnosed as an ectopic third molar. Removal of such ectopically impacted teeth has to be performed with utmost care due to its proximity to the orbital floor. Training for simple impactions are imparted to postgraduate students in dental schools. Complicated impactions such as this need to be performed by experienced oral and maxillofacial surgeons. It was explained to the patient and his parents that this needed to be removed surgically. The contents of the sinus cavity would also be cleared during surgery. They were in full agreement with the treatment plan and consented to surgery. Caldwell Luc procedure is the technique of choice for such impactions. Our hospital is a specialty center for Oral and Maxillofacial Surgery. Jaw joint surgery, orthognathic surgery, surgery for removal of odontogenic cysts and facial trauma surgery. Presence of an ectopic tooth and its implications Ectopic tooth eruption in the maxillary sinus is usually an incidental finding that is discovered during routine radiological examination. They could also become symptomatic and cause discomfort and pain as in the case of this patient. Development of a dentigerous cyst in relation to an ectopically erupted maxillary third molar within the maxillary sinus is very rare. These impactions can also arise from displaced dental follicles. Ectopic eruption occurs when a tooth is displaced from its normal position. This could be from pressure caused by pathological conditions such as cysts. It can also be idiopathic with displacement of the tooth bud occurring during development. This results in its eruption at an abnormal site. Such ectopic eruptions are most commonly seen in the dentate region. Successful removal of ectopically erupted right maxillary third molar tooth Under general anesthesia, a crevicular incision was made in the right maxillary region. A flap was then elevated to expose the maxillary bone. A window was made in the maxillary bone through the Caldwell Luc technique to gain entry into the maxillary sinus. This was followed by thorough sinus clearance. The impacted right third molar was removed. This was followed by irrigation of the sinus with antibiotics and closure of the wound with sutures. Complete resolution of symptoms after maxillary molar impaction surgery There was complete resolution of the patient’s swelling and discomfort at the time of checkup. The patient and his parents expressed their satisfaction before final discharge from the hospital. Surgery video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 21st, 2020 10:16 pm January 21, 2020

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Cosmetic Rhinoplasty – Broad Nose Reshaping Surgery

Patient with broad nose deformity with a flattened nasal tip The patient is a 31-year-old man from Panruti in Tamil Nadu, India. He had always disliked the shape of his nose. This had led to the patient feeling very self conscious in social situations. About two years ago, his friend had recommended a cosmetic surgeon in a nearby city. He was advised to undergo a nose job by the surgeon. The patient had undergone a rhinoplasty procedure performed by the surgeon. Both bone and cartilage play an important role in giving shape to the nose. Costochondral rib grafts had been harvested from the patient at the time of surgery. These grafts were used to augment the patient’s flattened nasal bridge. The patient however was not satisfied with the results of the surgery. This had resulted in a slight deviation of the nose to the right. This had caused the patient to become withdrawn and depressed. Growing concerned over this, his family had made enquiries regarding treatment centers for corrective surgery. They had subsequently been referred to our hospital for management of his broad nose deformity. Development of nasal forms over the millennia of human evolution Nasal shapes were classified first by Eden Warwick back in 1848. Nasal shapes are mainly influenced by racial origins. Shapes of the noses were influenced by climatic conditions that each race developed in. The shapes were thus crafted over several thousands of years of human evolution. Facial features are greatly influence by nasal shape. The narrow aquiline Caucasian nose developed in cold climes where a narrow aquiline nose enabled warming up of inhaled air. A broader African nose developed in hot climes where the air was cooled down during its passage through the nasal cavity. This perfectly explains the development of different nasal forms in various regions around the world. Anatomical nasal shapes and various nasal deformities Nasal deformities can be classified broadly under broad nose deformity, crooked nose deformity and flat nose deformity. These would include saddle nose deformity, dorsal nasal hump, and parrot beak deformity. Certain birth defects such as Down’s syndrome are associated with characteristic nasal deformities. Patients have a typically small nose with a flattened nasal bridge. Clinical examination of the nose Dr SM Balaji, Cosmetic Rhinoplasty Surgeon, examined the patient and obtained a detailed surgical history. The patient related that the previous surgery had resulted in a deviated nasal deformity. There was also no reduction in his broad nose deformity. He also stated that there were breathing difficulties during sleep. The patient wished to have a narrower nose with a prominent tip. Detailed treatment planning explained to the patient It was explained to the patient that a closed rhinoplasty would offer best results for his condition. Nasal augmentation would be performed with the use of perfectly shaped costochondral graft harvested from the patient. This would be followed by Weir excision for reducing the breadth of his nostrils. The patient and his parents were in agreement and consented to surgery. Successful correction of the nasal deformities with good nasal form Under general anesthesia, a right inframammary incision was made at the site of the previous surgical scar. The scar was excised and costochondral rib graft was harvested. The incision was then closed in layers with sutures. This was followed by a transcartilagenous incision in the right nostril and dissection was done up to the nasal dorsum. The previously placed graft was removed and the nasal dorsum was augmented using the harvested rib graft. This resulted in elevation of the nasal bridge and correction of the crooked nose deformity. A Weir excision was performed to reduce the broad nasal base. Closure of the incisions was done through the use of resorbable sutures and non resorbable sutures. Total patient satisfaction at the results of the surgery The result of the surgery was immediately visible. There was perfect nasal symmetry with correction of the crooked nose. The nose was also narrower without any compromise in function. The patient and his parents expressed their gratitude before final discharge from the hospital. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

January 11th, 2020 08:32 pm January 11, 2020

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Inauguration of upgraded new Cone Beam Computed Tomogram (CBCT)

[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_column_text]Balaji Dental and Craniofacial Hospital has always prided itself for keeping abreast with the latest technological advancements from around the world. Dr SM Balaji, Oral and Cranio-Maxillofacial Surgeon, is a renowned surgeon who uses cutting edge technology to provide the best surgical care for patients. We were the first in South India to acquire the CBCT scan in 2010. Our hospital has now upgraded its CBCT scan to the latest 2020 specifications marvel of imaging technology. This was recently inaugurated by Hon’ble K Vijay Kumar, IPS, Senior Security Advisor, Government of India and His Excellency Abdulla Shahid, Hon. Minister of Foreign Affairs, Republic of Maldives. The minister congratulated Dr SM Balaji on acquiring the latest CBCT and keeping updated with the latest technology from around the world. He fondly recalled the long standing relationship of over 20 years that his nation has had with Dr SM Balaji and spoke about the free surgical care being provided by Dr SM Balaji towards the rehabilitation of adults and children with cranio-maxillofacial deformities including cleft lip and palate. Congratulating Dr SM Balaji, Hon’ble K Vijay Kumar, IPS, spoke about his long standing association with Dr SM Balaji and talked about his contributions towards improving awareness about the importance of oral health in the country.[/vc_column_text][/vc_column][/vc_row][/vc_section][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6499″ img_size=”full”][/vc_column][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6500″ img_size=”full”][/vc_column][/vc_row][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6503″ img_size=”full”][/vc_column][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6504″ img_size=”full”][/vc_column][/vc_row][vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Salient features and technological upgrades in the latest 2020 CBCT scan” subheading=”” alignment=”left” custom_colors=”” class=””][vc_row_inner animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vc_single_image image=”6501″ img_size=”full”][/vc_column_inner][/vc_row_inner][vc_row_inner animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vc_column_text]The new upgraded 2020 CBCT scan is generations ahead of the older model and has many new features that showcase the latest in medical technology. There has been complete revamping of the software as well as hardware. Radiation exposure from a conventional CT is the equivalent of 120 x-rays. The older CBCT reduced this exposure to one-tenth to make it the equivalent of 10-12 radiographs. The latest CBCT scan has reduced this exposure to miniscule levels, boasting an exposure level of only 3-4 x-rays. This makes is very safe even for multiple uses in children. Some of the other added features include plotting of the course of nerves and blood vessels within bone as well as delineation of areas of differing bone density as well as accurate airway volume measurements. This can also predict growth parameters as well as create input images for three-dimensional printing. This makes it the ideal tool for treatment planning of complex cranio-maxillofacial surgeries that are routinely performed in our hospital. It is also the perfect aid for planning placement of dental implants within the bone, determining the extent of infection beyond the root apex for successful root canal treatments, visualizing the extent of bone destruction in cases of chronic periodontitis and other such treatments.[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][/vc_section]

January 10th, 2020 09:11 pm January 10, 2020

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Maxillary Dentigerous Cyst Surgery – Wisdom Tooth Removal

[et_pb_section fb_built=”1″ _builder_version=”3.22″][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] Patient with gradually increasing left face swelling and pain The patient is a 26-year-old year male from Porto Novo in Tamil Nadu, India. He began noticing the development of pain and swelling in his left upper jaw a few months ago. This has now increased to the point where there is severe pain and discomfort in that region. There is also a feeling of heaviness in that region. Examination at a local dental clinic for diagnosis of his problem He had presented at a local dental clinic where imaging studies had been obtained. This revealed the presence of an impacted molar in the left maxillary sinus. Suspecting this to be a dentigerous cyst, the dentist had immediately referred the patient to our hospital for management. The patient gives a history of undergoing extraction of his left upper second molar a few months ago. Our hospital is a renowned centre for oral and maxillofacial surgery in India. Treatments ranging from simple extractions to complicated craniofacial surgeries are routinely performed at our hospital. Facial trauma surgery and jaw reconstruction surgery are specialty surgeries performed here. Facial cosmetic surgery and cosmetic rhinoplasty are also addressed here at our hospital. Eyelid surgery to address epicanthal folds is also performed in our hospital. We are a super-specialty center for closed rhinoplasty as open rhinoplasty can leave behind residual scars. Initial presentation at our hospital for management of his condition Dr. SM Balaji, Jaw Reconstruction Surgeon, examined the patient. He then ordered for a 3D CT scan and other imaging studies for the patient. This revealed a dentigerous cyst enclosing an impacted third molar in his left maxillary sinus. The condition was explained in detail to the patient and his parents. Treatment planning for enucleation of the cyst along with extraction of the molar and sinus clearance was explained to the patient. The patient and his parents were in complete agreement with the treatment planning and consented to surgery. Ectopic maxillary molar teeth and their implications An ectopic tooth in the maxillary sinus is usually found incidentally on imaging. Dentigerous cysts associated with ectopically erupted maxillary third molars are very rare. Dentigerous cysts are more commonly associated with impacted mandibular third molars. Ectopic eruptions occur when teeth do not erupt in their anatomical positions. These are most commonly seen in the dentate region. Displacement of the tooth to the ectopic site may either be developmental or pathological. Successful enucleation of dentigerous cyst from the maxillary sinus cavity Under general anesthesia, a crevicular incision was made in the left maxillary region. A flap was elevated followed by exposure of the cyst through the Caldwell Luc technique. The dentigerous cyst was removed along with the impacted left third molar. Sinus clearance followed by irrigation was then performed. The incision was then closed with resorbable sutures. Patient expresses his happiness at the results of the surgery The patient and his parents were extremely relieved after the surgery. There was complete resolution of the swelling and discomfort following the procedure. They expressed their satisfaction before final discharge from the hospital. [/et_pb_text][et_pb_video _builder_version=”4.9.2″ _module_preset=”default” src=”https://youtu.be/kqqa64dTwp0″ hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]

January 6th, 2020 09:08 pm January 6, 2020

smbalajiSurgery 331

Caldwell Luc Closure of Oroantral Fistula

Patient undergoes traumatic extraction one month ago The patient is a 54-year-old lady from Chennai in Tamil Nadu, India. She had developed pain in the right upper back teeth region around a month ago. An x-ray was taken at an outpatient clinic of a dental school and she had been advised extraction of the right upper second molar. It had been a very difficult extraction and the entire tooth had been removed in pieces. Subsequently, the patient had experienced swelling in the region followed by heaviness on the right side of her face. She described a feeling of having fluid flowing from the right side of her face down her throat. Her family had subsequently made enquiries regarding the best dental hospital in Chennai and were referred to our hospital. Our hospital is a premier oral and maxillofacial surgery center in India. Many patients come to our hospital after unsuccessful surgeries elsewhere. We are renowned for corrective maxillofacial surgery in India. Hundreds of patients with chronic maxillofacial problems have been successfully rehabilitated in our hospital. Initial examination upon presentation at our hospital Dr SM Balaji, Oral and Maxillofacial Surgeon, examined the patient and ordered pertinent imaging studies including a 3D CT scan. The patient stated that she has a history of maxillary sinusitis. Her imaging studies revealed that her maxillary sinus was filled with an exudate. There was also an oroantral fistula present at the site of the traumatic extraction. In addition, a full thickness defect was also noted on the bony nasal septum. The patient had previously undergone a septoplasty approximately three years ago. Nose blowing test was positive. Oroantral communication versus oroantral fistula An oroantral fistula is an abnormal condition where the maxillary sinus is exposed to the oral cavity through an epithelialised fistula. This is a pathologic condition and is not to be confused with oroantral communication. An oroantral communication, if left untreated, can either heal spontaneously or progress into oroantral fistula. The fistulous opening is in a majority of cases situated on the alveolus. Treatment planning explained and consent obtained It was decided to perform an oroantral fistula closure along with clearance of exudates from the maxillary sinus. Caldwell Luc procedure is the ideal surgery for this condition. The surgery was explained in detail to the patient. She then provided consent for the surgery. Surgical closure of the oroantral fistula Under adequate general anesthesia, a crevicular incision was first made in the right maxillary region. A flap was then elevated and the oroantral fistula exposed. There was purulent discharge within the antrum. Through Caldwell Luc technique, a window was created and thorough maxillary sinus clearance was done. Irrigation was done with antibiotics and thoroughly flushed until there was return of clear irrigant. The flap was then reapproximated and sutured using resorbable sutures. Successful resolution of symptoms and antral infection There was no residual fullness felt by the patient. She expressed that all her symptoms had completely resolved and she felt completely fine. The patient expressed her happiness at the results of the surgery and thanked the surgical team before final discharge from the hospital. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

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Caldwell Luc Closure of Oroantral Fistula

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About Us

International Patients

Maxillofacial Surgery

Cosmetic Surgery

Craniofacial Surgery

Syndrome Management

Dental Procedures

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