Dr SM Balaji attends the Asia Pacific Regional Organization Council Meeting
Dr SM Balaji, Vice President, International College of Continuing Dental Education (ICCDE) attended the Asia Pacific Dental Federation/Asia Pacific Regional Organization (APDF/APRO) Council meeting where many issues related to the development of dentistry in Asia were discussed and plans formulated towards implementation of decisions made at the meeting.He was also an active participant at various regional meetings throughout the congress in recognition of his vast experience in dealing with issues that are pertinent at regional levels throughout the world.
Pakistan Dental Association’s Humanitarian Award conferred on Prof SM Balaji
Prof SM Balaji is chosen for the Humanitarian Award Prof SM Balaji is a Chennai based Craniomaxillofacial Surgeon. The Pakistan Dental Association (PDA) chose him for its Humanitarian Award. The award was presented to him at the 40th Asia Pacific Dental Congress held at Manila, Philippines. Prof SM Balaji’s free surgeries for underprivileged children The Asia Pacific Dental Federation (APDF)/PDA sponsors children with complex surgical needs. Treatment is at the best surgical centers abroad. It has been sending children with complex craniofacial developmental abnormalities to Chennai. Prof SM Balaji has been operating on them since 2010. He performs these complicated surgeries for free as a part of his social initiative. Over 120 such children have benefitted from this association. This is the eighth year Prof SM Balaji has been performing this service. The Pakistan Dental Association confers Humanitarian Award on Dr SM Balaji The Pakistan Dental Association decided to honour Prof SM Balaji for his contributions. This was through its highest Humanitarian award. The award recognized his services towards the rehabilitation of these children. The PDA conferred this award on Dr SM Balaji at a special award ceremony. This was at the 40th Asia Pacific Dental Congress 2018 meeting in Manila, Philippines. The PDA President, Dr Mahmood Shah, Vice President, Dr Asif Arain and Secretary General Dr Nasir Ali Khan presented Prof SM Balaji with this prestigious award. Of note, Prof SM Balaji is the first Indian to receive this honor.
Infected dentigerous cyst-Segmental Resection & Reconstruction Surgery
Patient presents with swelling in the anterior mandible This patient is a middle aged lady from Villupuram. She first noticed a swelling on the left side of her mandible. This had led to a gradual loosening of the anterior mandibular teeth. An increase in the size of the swelling alarmed her and she went to a dentist. He obtained an x-ray, which revealed a cyst. Suspecting a simple cyst, the dentist had removed the cyst, which had an impacted tooth within it. The swelling however returned and became infected. He then referred her to our hospital for further management. Biopsy confirms diagnosis of infected dentigerous cyst Dr SM Balaji examined the patient and ordered diagnostic studies and a biopsy. Biopsy revealed the presence of an infected dentigerous cyst. The patient agreed to surgery after the treatment plan was presented to her. Rib grafts obtained to fill in area of bony defects after enucleation Under general anesthesia, two rib grafts were first obtained from the patient. A Valsalva maneuver demonstrated absence of perforation into the thoracic cavity. The incision was then closed in layers with sutures. Successful enucleation of dentigerous cyst followed by bone graft A mucogingivoperiosteal flap was first raised and the region overlying the cyst exposed. The cyst was then enucleated in toto along with the extraction of teeth overlying the cyst. The rib graft was then shaped into pieces to fit into the bony defect. These pieces were then fixed with screws and the flap sutured. The patient recovered from general anesthesia without any complications. Surgery Video
Square face correction with large masseter and enlarged gonial angle reduction
Young man presents for square face reduction surgery The patient is a young man with a broad face due to large masseter and enlarged gonial angle. He had always been unhappy about this and desired surgical correction. He presented to our hospital to undergo square face correction. Dr SM Balaji explained the treatment plan to the patient who agreed to the surgery. Square face reduction surgery Under general anesthesia, a left-sided mandibular vestibular incision was first made. Dissection was then carried down to the region of the gonial angle and masseter. Excess masseter muscle was then removed followed by reduction of the gonial angle. This resulted in adequate reduction of left facial breadth. The same procedure was then carried out on the right side. The patient is very happy with the results After adequate reduction had been obtained, the incisions were then closed with sutures. The patient expressed his happiness at the results before discharge from the hospital. Surgery Video
Depressed Nose Augmentation Rhinoplasty Surgery
Young lady desiring surgical correction presents to hospital This young lady is from Madurai. She had always desired a sharp nose. Desiring surgical correction, her family had searched for the best nose correction surgeon. This led them straight to our hospital. Examination of the nose with detailed treatment planning Dr SM Balaji examined the patient and recommended costochondral graft placement. This would raise the bridge of the nose and give the patient’s nose a sharp profile. The patient was in agreement with this treatment plan. Harvesting of costochondral rib graft from the patient Under general anesthesia, a costochondral graft was first harvested from the patient. A Valsalva maneuver demonstrated absence of perforation into the thoracic cavity. Following this, the incision was then sutured in layers. Surgical augmentation of a depressed bridge of the nose Attention was then turned to the nose. All incisions were intranasal to avoid scar formation. The costochondral graft was then crafted to the right size. This was then tunneled to the bridge of the nose and stabilized with sutures. The patient now had a sharp nose with a straight bridge. The patient expressed her happiness at the results of the surgery before discharge.
Fibrous Dysplasia Bulk Reduction Surgery
Young boy presents with fibrous dysplasia This young boy is from Nellore. He has the diagnosis of fibrous dysplasia. Fibrous dysplasia is a disorder of the bone where fibrous tissue develops in place of bone. This weakens bone and can lead to fractures. The patient has this swelling straddling his nose and extending on both sides. His parents brought him to our hospital for reduction of the fibrous tissue. A local dentist referred them here for cosmetic surgery. Patient examined and treatment plan explained in detail Dr SM Balaji examined the patient and ordered radiographic studies. Diagnosis was confirmed as fibrous dysplasia. He explained the treatment planning to the parents who agreed to the surgery. Surgery for fibrous dysplasia done with good esthetic results A vestibular incision was first made in the anterior maxillary region. Dissection was then done down to the fibrous tissue overlying the nasal region. The fibrous tissue was burred and trimmed until attaining normal facial anatomy. Incision was then closed with sutures. The patient and his parents expressed their satisfaction before final discharge.
Dentigerous Cyst -Simple Enucleation Surgery
Boy with swelling referred to our hospital for treatment The patient is a little boy from Vadodara. He had complained of a swelling in his left jaw. His parents took him to a local dentist. The dentist suspected this to be a dentigerous cyst. He then referred them to our hospital for management. Dentigerous cyst confirmed and treatment plan explained Dr SM Balaji examined the patient and ordered a 3D CT. This revealed a dentigerous cyst with an impacted second molar within it. He advised surgical removal of the cyst and the parents agreed. Dentigerous cyst enucleated without any complications Under general anesthesia, a mucogingivoperiosteal flap was first raised. This exposed the bony swelling enclosing the dentigerous cyst. The cyst was then enucleated and removed. Following this, the flap was then sutured back into position. The patient recovered without event from the surgery
Macrostomia, Tongue tie and Ear tags, extra Ear Lobule Correction Surgery
A long drawn search for the best facial cosmetic surgeon for this child This 5-year-old girl from Itarsi was born with a mouth that was very wide on the right side. The medical term for this condition is macrostomia. Her macrostomia and hemifacial microsomia resulted in underdevelopment of her right face. There may be absence of external ear in this condition. Ear tags may be present. The ear tags may contain cartilaginous tissue. If so, they need to be first dissected, repaired and sutured back. This child will need several surgeries later for reconstruction of the lower jaw. Macrostomia correction is first done and the ear tags removal is then done. She needs complete follow up of growth of mandible on the right side. She also had a tongue tie and ear tags with an extra lobe of the right ear. The tongue tie was causing abnormal speech patterns in the child. Her parents had searched far and wide for the best facial deformity surgeon to correct this. Their search had been futile for many years. It was only around six months ago that they met the parents of a similar child. Surgery performed for that child at our hospital had resulted in perfect correction. This led the parents of this little girl straight to our hospital. Treatment plan explained to the parents Dr SM Balaji examined this little girl and ordered diagnostic studies. He explained the proposed surgical plan to her parents. They were in complete agreement with his treatment plan. This was the first stage of surgical correction for this little girl. Tongue tie and macrostomia correction surgery Under general anesthesia, the tongue tie was first addressed. The lingual frenum was then dissected free to enable full extension of the tongue. This would enable normal speech for the child. Attention was next turned to the macrostomia correction. The vermillion border on the right side was first dissected. The excess tissue was then removed. The vermillion border was then sutured to ensure symmetry of the lips. Ear tag and extra ear lobe removal surgery Attention was then directed to the ear tags and extra ear lobe on the right. The ear tags were first dissected free and excised. The extra ear lobe was also addressed in similar fashion with good esthetic results. Suturing of all incisions completed the surgical procedure. The patient’s parents expressed their complete satisfaction with the results before discharge. Surgery Video
Facial asymmetry correction- condylar hyperplasia already operated but failed, maxillary shortening, buccal fat pad transfer, malar and mandibular body augmentation surgery
Patient with failed surgery elsewhere presents for correction The patient is a young woman with failed condylar hyperplasia surgery performed elsewhere. She presented to our hospital for correctional surgery. Dr SM Balaji examined the patient and ordered detailed studies for the patient. Rib graft and buccal fat pad graft obtained from the patient Under general anesthesia, a rib graft was first harvested from the patient. Valsalva maneuver demonstrated a patent thoracic cavity. The incision was then closed with sutures. This was next followed by harvesting of a buccal fat pad graft from the right cheek. Augmentation of the mandibular body done with grafts A left sided maxillary vestibular incision was next made. The bone grafts were then shaped and fixed with screws in this region. Attention was next turned to the mandible. A mucogingivoperiosteal flap was then raised. The bone grafts were then screwed in place in the molar region. This led to adequate augmentation of the body of the mandible. Maxillary repositioning and buccal fat pad transfer performed Attention was next turned to the anterior maxillary region. An osteotomy was then performed and the maxilla repositioned with four holed plates. This was then followed by transfer of the buccal fat pad graft to the left cheek. All incisions were then closed with sutures. The patient expressed complete satisfaction with the results of the surgery before discharge. Surgery Video
Large dentigerous cyst of maxilla enucleated. Root canal treated teeth saved and defect filled with rib graft
Young boy with dentigerous cyst presents with nonvital teeth The patient is a young boy who presented with a swelling in the left anterior maxilla. Dr SM Balaji examined the patient. The teeth in the area of the swelling were nonvital. Radiograph revealed the presence of a large dentigerous cyst in that region. Treatment planning was for surgical excision of the cyst. Dentigerous cyst enucleated and teeth saved A mucogingivoperiosteal flap was first raised in the anterior maxillary region. There was a supernumerary tooth present within the dentigerous cyst. The dentigerous cyst was then enucleated and removed with care taken to save all RCT teeth. A rib graft was then harvested to fill in the bony defect. Valsalva maneuver demonstrated lack of perforation into the thoracic cavity. Bony defect filled with harvested rib graft The harvested rib graft was then cut and shaped to fit into the bony defect. The graft was then fixed with screws. The flap was then sutured back in place. Postoperative healing was uneventful. Surgery Video