This patient first noticed a developing asymmetry due to gradual atrophy of his left lower jaw a few years back and had been diagnosed with Parry Romberg disease
Read moreFacial Asymmetry Correction with Fat Graft for Parry Romberg Disease
This patient first noticed a developing asymmetry due to gradual atrophy of his left lower jaw a few years back and had been diagnosed with Parry Romberg disease
Read moreFacial Asymmetry Correction with Fat Graft for Parry Romberg Disease[et_pb_section fb_built=”1″ _builder_version=”4.9.4″ _module_preset=”default”][et_pb_row _builder_version=”4.9.4″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.4″ _module_preset=”default”][et_pb_text _builder_version=”4.9.4″ _module_preset=”default”] Young Man Notices Gradual Development of Facial Asymmetry The patient is a 26-year-old man from Thalassery in Kerala, India. He has had a slowly progressing facial asymmetry for many years now. There was a gradually developing swelling of the right midfacial region. A biopsy had been obtained and he had been diagnosed with fibrous dysplasia. He had chosen to ignore it as it was not causing him any functional difficulties. Disfigurement caused by Fibrous Dysplasia and its Probable Etiology Fibrous dysplasia is a rare disorder of the bone where normal bone is replaced by fibrous tissue. There is an overgrowth of this fibrous tissue, which results in progressive facial disfigurement. The bone is also weakened by this fibrous tissue. It is thought to result from a genetic mutation at birth but is not hereditary. There is a dull ache in the region of the affected bone. Fractures are also common when it affects the limb bones. The only treatment available is the surgical removal of the fibrous tissue. Patient Decides to Undergo Surgical Correction of his Deformity The growth has now progressed to the point where it is causing self-esteem problems for the patient. He was beginning to avoid social interactions because of the extreme facial disfigurement. His parents researched the internet for the best hospital to get this addressed. They also made widespread inquiries regarding the same. Our hospital is a premiere center for facial plastic surgery in India. Many patients have undergone facial cosmetic surgery and facial reconstructive surgery at our hospital. He and his parents zeroed in on our hospital for his fibrous dysplasia surgery. Our hospital stringently follows protocols laid down by the American Society of Plastic Surgeons. We also conform to the guidelines laid down by the European Society of Aesthetic Plastic Surgery. Many referrals are made from centers in the European Union to our hospital for correction of facial deformities. Patients from around the world come to us for reconstructive plastic surgery and facial asymmetry surgery. We utilize advanced facial biometric systems for facial asymmetry correction. Facial implants can be utilized when there is a bony deficiency causing facial asymmetry. Initial Consultation and Treatment Planning at our Hospital Dr. SM Balaji, facial cosmetic surgery, examined the patient and spoke with him at length. Biopsies and imaging studies were ordered including CT scans. This revealed a diagnosis of fibrous dysplasia of zygoma and orbit along with the involvement of the temporal bone. The fibrous overgrowth had caused gross disfigurement of both bones. Our hospital also offers comprehensive imaging services including magnetic resonance imaging (MRI) scan and bone scan. He explained the surgical treatment process and the cosmetic improvement to the patient. All queries raised by the patient and his family were addressed. The patient and his parents expressed understanding and consented to surgery. A 3D stereolithographic model of the patient’s skull was obtained. The fibrous overgrowth was studied and presurgical analyses were performed. It was then decided to proceed with surgery. Surgical Removal of Fibrous Overgrowth The affected regions of the zygoma and temporal bone were approached through a hemicoronal incision. No other approach would enable satisfactory removal of the fibrous tissue. Surgery progressed through dissection of the galea and temporal fascia. Care was taken to also preserve blood supply to the temporalis muscle to prevent any postsurgical atrophy. The frontalis and orbicularis oculi branches of the facial nerve were protected throughout the surgical procedure. Dysplastic fibrous overgrowth was removed meticulously. Normal bony contour was established through the removal of the excess tissue. This would restore symmetry to his face. The fascia was sutured with retraction of the temporal muscle after adequate removal. This was to ensure that there would not be a hollowed-out appearance to the region. The incision was finally closed with staples. Postsurgical Improvement in Facial Appearance The patient and his parents were very happy with the results of the surgery. There was a tremendous improvement in the cosmetic appearance of the face. Improvement in the patient’s self-confidence was apparent shortly after surgery. He and his parents expressed their total satisfaction with the treatment process at our hospital. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/A4e0AFHj1AA” _builder_version=”4.9.4″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreFibrous Dysplasia of Zygoma and Orbit[et_pb_section fb_built=”1″ admin_label=”section” _builder_version=”3.22″][et_pb_row admin_label=”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=”4.9.4″ _module_preset=”default”] What is Hemophilia? Hemophilia is a rare condition in which the blood fails to clot properly due to a lack of blood-clotting proteins (clotting factors). If you have haemophilia, you can bleed for a longer period of time after an injury than if your blood clotted normally. Small cuts are typically not a big deal. World Hemophilia Day World Hemophilia Day is an international day to raise awareness of haemophilia and other bleeding disorders. It is held each year on April 17, the birthday of Frank Schnabel, the founder of the World Federation of Hemophilia. Since 1989, World Hemophilia Day has brought together the whole bleeding disorders community to celebrate the ongoing developments in treatment while also raising awareness and bringing understanding and attention to problems related to proper care to the general public. Managing Treatment in a New World: Adapting to Change The aim of World Hemophilia Day is to bring the global bleeding disorders community together. With the COVID-19 pandemic wreaking havoc on people with bleeding disorders, the goal has never been more critical. The world has changed dramatically in the last year, but one thing has remained constant: we are all in this together. Join us on April 17, 2021, and tell us how you’ve adapted to change during this extraordinary period, and how you’re working hard to help sustain treatment in a new world! Dr. SM Balaji’s Message on World Hemophilia Day [/et_pb_text][et_pb_video src=”https://youtu.be/P6TKGURsuIQ” _builder_version=”4.9.4″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreWorld Hemophilia Day 2021[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] Orbital Dystopia Surgery One of the most common clinical symptoms of craniofacial malformation is orbital dystopia. The concept dystopia refers to the orbits’ mono- and bilateral asymmetry in at least one of the three-dimensional planes. The clinical examination of the patient is used to make the diagnosis, which is supported by diagnostic instruments such as teleradiography in both normal projections, axial computed tomographic (CT) scans at a rate of 1:1 via the neuro-orbital plan, and three-dimensional CT. A young man with Grievous Facial Injuries from Road Traffic Accident This is a 24-year-old man from Ranchi in Jharkhand, India. He had been involved in a horrific road accident. There was also blindness caused by the loss of his left globe. This had resulted in left-sided facial fractures involving his middle facial region. These fractures involved many bones causing asymmetry. There was the involvement of his orbital bone, nasal bone, zygoma and maxilla. He had undergone a series of surgeries in various hospitals. These had left him with a facial asymmetry and severe orbital dystopia. He descended into a depression because of the turn of these events. His worried parents had consulted far and wide for the best hospital to address his problems. They were referred to our hospital by a leading plastic surgeon in their hometown. They contacted our hospital manager and fixed an appointment for a consultation. Board-certified facial cosmetic surgeons perform these surgeries in Western nations. Oral and Maxillofacial surgeons who are also cosmetic surgeons perform these in India. Leading Center for Facial Trauma Surgery In India Our hospital is a leading center for redo facial trauma surgery in India. Many patients with complications arising from surgery performed elsewhere present to our hospital. Our hospital serves as a tertiary referral center for craniofacial surgery in Asia. We are a specialty center for prosthetic eyeball surgery in India. Our in-house prosthetic laboratory provides custom-made shells to many centers around the country. Specialty Center for Redo Facial Cosmetic Surgery Dr SM Balaji, facial cosmetic surgeon, examined the patient and obtained imaging studies. The patient had gross facial asymmetry. This was caused by the malunion of the facial fractures. There was a widening of the canthal bay due to the nasoorbitoethmoidal fracture. He also had a depressed nose due to a fracture of the nasal bone. CT scans were also obtained for the evaluation of the cribriform plate. Treatment planning was presented to the patient and he consented to surgery. Facial Asymmetry Correction Performed in our Hospital A costal cartilage graft was first harvested to augment the depressed nose. The sites of the malunited fractures were then accessed. The plates from the previous surgeries were also removed. A Titanium mesh with Medpor was then introduced through the subconjunctival incision. This resulted in the reconstruction of the fractured orbital floor. A lateral canthopexy was then performed for the correction of the canthal bay deformity. This was next followed by augmentation rhinoplasty. The costal cartilage graft was used to raise the bridge of the flat nose. This resulted in the correction of his nasal deformity. An orbital conformer was then placed at the conclusion of the surgery. This resulted in the correction of his facial deformities. The patient expressed his satisfaction with the results of the surgery. His parents too conveyed their gratitude before final discharge from the hospital. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/dgOxpYSD2QI” _builder_version=”4.9.2″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreOrbital Dystopia Surgery with Medial Canthopexy and Rhinoplasty[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] What is Odontogenic Keratocyst An odontogenic keratocyst is a benign but locally violent developmental cyst that is uncommon. It usually affects the posterior mandible and appears in the third decade of life. Odontogenic keratocysts account for about 19% of all jaw cysts. The cyst that develops from the cell rests of the dental lamina is known as an odontogenic keratocyst (OKC). It can appear anywhere in the mouth but is most commonly found in the mandible’s posterior region. What causes odontogenic cysts? Cells and tissues involved in natural tooth growth give rise to odontogenic jaw tumors and cysts. Other cancers that involve the jaws can be nonodontogenic, which means they can arise from tissues within the jaws that are unrelated to the teeth. How is odontogenic Keratocyst treated? Decompression, marsupilization, enucleation with or without adjunct (Carnoy’s solution, cryotherapy), and resection were also implemented as surgical methods. keratocystic odontogenic tumour (KCOT) may be handled conservatively with enculation and Carnoy’s solution or cryotherapy, depending on other research. Initial Diagnosis in his Hometown The patient is a 24-year-old male from Karur in Tamil Nadu, India. Approximately two years ago, he began developing swelling in his anterior lower jaw. At first, he had neglected it, but it continued to grow. Alarmed at the increase in size, he presented to a local oral surgeon. He had undergone examination followed by a biopsy of the lesion. This returned with a result of odontogenic keratocyst. It was explained that though it was benign, it was also aggressive. The lesion extended from the left second premolar to the right second premolar. Referral to our Hospital for Management of His Jaw Lesion He was advised to undergo jaw resection surgery at the earliest. A referral was made to our hospital as we are one of the leading oral surgical hospitals in India. Our hospital is a leading jaw reconstruction center in India. Patients with loss of bony tissue in the jaws are referred to us for corrective surgery. Reconstruction from cystic lesions like dentigerous cyst is also performed in our hospital. Jaws are affected by various odontogenic cysts. The lower jaw is more affected more than the upper jaw. Cyst repair surgery of the jaws requires reconstruction for correcting the bony defect left by the cyst. Corrective jaw surgery through reconstruction is performed after excision of cyst. Jaw cysts are also common in basal cell carcinoma syndrome. Oral and Maxillofacial Surgeon with over 30+ Years Experience Dr. SM Balaji, jaw reconstruction surgeon, examined the patient and obtained imaging studies. A biopsy confirmed the previous diagnosis of odontogenic keratocyst. Treatment planning was explained to the patient. Our hospital is a specialty center for jaw repair surgery. Jawbone surgery can involve either reduction or reconstruction of jaws. Bone repair surgery lies within the purview of oral surgeons and orthopedic surgeons. Treatment Planning and Successful Surgical Rehabilitation It was also explained to him that rib grafts would be used for jaw reconstruction surgery. Total rehabilitation would include the replacement of lost teeth with dental implants. He then consented to undergo surgery. Surgery commenced with harvesting rib grafts for jaw reconstruction. A Valsalva maneuver confirmed that there was no perforation into the thoracic cavity. The incision was then closed in layers. The affected region of the law was next resected. This was followed by reconstruction of the jaw with the rib graft. Titanium screws were used to fix the grafts to the jaw. The patient was advised to return in four months after the consolidation of the grafted bone with the jaw. Placement of Dental Implants after Consolidation of Graft Bone He returned six months later and imaging revealed a union of the graft with the jawbone. A flap was then raised and the titanium screws were removed. Premium dental implants were then fixed to the reconstructed jaw bone. This would undergo osseointegration with surrounding alveolar bone in 4-6 months. Total Rehabilitation following Odontogenic Keratocyst Surgery Shade-matched ceramic crowns would be placed over the dental implants. This would be fabricated in our in-house dental laboratory. The patient would have full restoration of function following treatment at our hospital. Surgery Video – Odontogenic Keratocyst [/et_pb_text][et_pb_video src=”https://youtu.be/ZbnfFqOhUKM” _builder_version=”4.9.2″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreOdontogenic Keratocyst – Jaw Reconstruction and Dental Implants[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] Hon’ble Abdulla Shahid, Minister of Foreign Affairs, Maldives meets with Dr. SM Balaji at the India Today Conclave 2021 Hon’ble Abdulla Shahid, Minister of Foreign Affairs, Republic of Maldives, visited India to attend the India Today Conclave 2021 that concluded recently at the Taj Coromandel in Chennai. He warmly greeted Dr. SM Balaji who was also an invitee at the Conclave. They discussed many issues that were related to the healthcare system of the Republic of Maldives. High Praise for Dr. SM Balaji’s contributions to the Island Nation During their interaction, the Hon’ble Abdulla Shahid recalled Dr. SM Balaji’s contribution through his free surgical missions to the island nation’s hospitals, including IGMH and Hulhumale Hospital in Male, Gan Regional Hospital in Gan and other regional hospitals at Kulhudhuffushi, Addu and various other atolls. He spoke about the transformation of the lives of children and young adults with craniofacial birth deformities at these government hospitals after corrective surgery by Dr. SM Balaji. He also emphasized Dr. SM Balaji’s contribution to the Maldivian Healthcare System, which included writing an oral healthcare book entirely in Dhivehi, the Maldivian language. Dr. SM Balaji interacts with various Dignitaries at the India Today Conclave Dr. SM Balaji also met with Mr. Shashi Tharoor, Congress MP & Former Minister of State for Human Resource Development, Mr. Ram Madhav, Former National General Secretary, Bharatiya Janata Party and Mr. Rahul Kanwal of India Today who moderated the discussions at the conclave. Minister visits Dr. SM Balaji at Balaji Dental and Craniofacial Hospital, Chennai During the course of his visit to Chennai, Hon’ble Abdulla Shahid paid a visit to Balaji Dental and Craniofacial Hospital, which is a leading, Chennai-based surgical centre for Craniofacial Surgery. He visited a recuperating Maldivian child who had undergone surgery with Dr. SM Balaji. The young child, as an infant, had a rare, rapidly enlarging tumor called Cemento-ossifying fibroma of both the upper and lower jaws. Use of Cutting Edge Technological Advances for the Treatment of the Child Many international medical facilities had turned away the parents due to the complexity of the child’s clinical presentation. Dr. SM Balaji took him under his care, removed the tumour and successfully rehabilitated him. To create a new jaw, he used novel tissue growth guiding proteins – rhBMP2. The lower jaw was successfully completed some time ago and the upper jaw was revised to accommodate the child’s growth. The Hon’ble minister expressed his heartfelt admiration for the child and congratulated him on his recovery from the ordeal. He also conveyed his sincere appreciation to Dr. SM Balaji for readily providing help to the young Maldivian child, assisting him in conquering the disease and enabling him to lead a normal life. [/et_pb_text][et_pb_gallery gallery_ids=”4382699,4382700,4382701,4382702,4382703,4382704,4382705,4382706″ posts_number=”8″ db_images_per_row=”2″ db_image_row_spacing=”10.4%” db_image_object_fit=”cover” dbdb_version=”3.5.2″ show_title_and_caption=”off” show_pagination=”off” _builder_version=”4.9.2″ _module_preset=”default” border_width_all=”1px”][/et_pb_gallery][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreHon’ble Abdulla Shahid, Minister of Foreign Affairs, Maldives visits BDCH[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] Facial Paralysis Surgery in India What is Facial Paralysis? Bell’s palsy can be caused by a viral infection. It almost never happens more than once.Bell’s palsy is described by muscle weakness, which causes one-half of the face to droop.Bell’s palsy normally goes away on its own after six months. Physiotherapy can help prevent muscles from contracting indefinitely. Patient with Facial Paralysis seeks Solution for his Problem The patient is a 27-year-old male from Rourkela in Odisha, India. He has had long-standing facial paralysis on the right side of his face. There was a drooping of the corner of the mouth on the affected side. He had tried a variety of medical treatments, which failed to address his problem. Referral to our Hospital for Treatment of his Condition This had left him feeling very frustrated. Seeking a solution, he had visited a cosmetic surgeon in his hometown. He underwent a dynamic reanimation with temporalis reanimation surgery. There was no improvement in his facial paralysis and this surgery was a complete failure. An internet search for the best facial paralysis surgery hospital in India had brought up our name. Having satisfied himself with the search results, he contacted our hospital manager and fixed an appointment for an initial consultation. Specialty Center for Facial Cosmetic Surgery in India We are a leading center for facial paralysis surgery in India. Our hospital is well known for facial plastic surgery in India. We are a specialty center for the correction of drooping mouth. This most commonly is caused by facial paralysis. We offer advanced treatments with the latest innovations from around the world. The cost of lip paralysis surgery in India is a fraction of what it costs in the West. Board-certified plastic surgeons often perform these surgeries in Europe and Japan. Regaining Movement in Paralyzed Face Facial reanimation surgery is also performed in our hospital. Patients come from around the world for this surgery. The patient regains the ability to emote following this surgery. Surgery for Correction of Facial Deformities Many conditions lead to facial asymmetry. The asymmetry can either be isolated to the soft tissue like in facial paralysis. It can also be due to underlying bony deformities. Facial palsy is caused by loss of innervation to facial muscles on one side supplied by the facial nerve. Viral infections are a frequent cause of facial palsy (Bell’s palsy), but a majority of such cases recover spontaneously. We also specialize in facial asymmetry surgery. Scores of patients have been rehabilitated after undergoing surgery in our hospital. Initial Consultation at our Hospital Dr. SM Balaji, facial cosmetic surgeon, examined the patient. He obtained a detailed history and spoke with the patient at length. Treatment planning was discussed with the patient. The mechanism of static suspension surgery was explained to him. He was encouraged to ask questions and clear his doubts. Once all his questions were answered to his fullest satisfaction, he expressed understanding and consented to undergo surgery. Successful Cosmetic Rehabilitation of Facial Paralysis Surgery commenced with harvesting a fascia lata graft from the thigh. The incision was closed with sutures once the graft was harvested. Attention was next turned to the face. An elliptical incision was made over the nasolabial fold. Orbicularis oris muscle fibers were then identified. The fascia graft was tunneled up to the zygomatic arch. The graft was then looped around the arch to form a circumzygomatic sling. Care was taken to ensure that there was no damage to any nerves or vessels. Both ends of the fascia lata sling were then sutured to the orbicularis oris. There was a good improvement of facial symmetry following this procedure. A lateral tarsorrhaphy was also performed as his cornea was getting ulcerated due to his inability to oppose the left eye. Total Patient Satisfaction with Results of Surgery The patient was very happy with the results of the surgery. He expressed his gratitude to the surgical team before discharge from the hospital. Surgery Video [/et_pb_text][et_pb_video _builder_version=”4.9.2″ _module_preset=”default” src=”https://youtu.be/BjVnhd8E8GM” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreFacial Paralysis Surgery – Static Suspension[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] The patient undergoes root canal therapy for left upper central and lateral incisors The patient is a 20-year college-going male from Chennai in Tamil Nadu, India. He is an avid sportsman and has been involved in sports from a young age. Around five years ago, while playing football, an opponent’s head had crashed against his upper left central and lateral incisor teeth. Since it had been around the time of his tenth board exams, he had self-medicated with analgesics without visiting the dentist and the pain had subsided. A few months later, he noticed that the crowns of both teeth had turned slightly darker. There was also a dull ache in the region. He had rushed to his family dentist who had informed him that the two incisors had turned nonvital due to the injury. Nonvital tooth root canal treatment successfully completed on the two upper incisors Root canal therapy had been advised for the two teeth and had been successfully completed. The pain subsided completely. Ceramic crowns had been advised by the dentist for the two teeth. The patient had however completely forgotten about that and had got on with the business of daily living. Reinjury to the same two teeth while playing competitive cricket with friends A few days ago, the patient had been playing cricket with his friends. There was a repeat of the previous accident when he collided with another fielder while trying to complete a difficult catch. This had ended badly for him with the lower half of his lateral incisor cleanly breaking off. There was a lot of pain in the region following the collision. It was only after he got back home that he noticed that the central incisor was mobile. His parents immediately rushed him to their dentist. He obtained radiographic images of the two teeth and explained to them that there was a horizontal root fracture of his central incisor. Explaining further, he said that the tooth had to be extracted. Realizing that the tooth would be lost, the patient wanted a dental implant to replace the missing tooth. Necessity for atraumatic extraction of fractured tooth fragments for implant success The dentist explained to them that the broken root fragment had to be removed atraumatically to ensure that the socket structure was preserved. This would have to be done very skillfully as a root canal treated tooth would be brittle and prone to crumbling. He said that this was imperative for successful dental implant surgery. The American Association of Endodontists advocates this treatment protocol for horizontal fractures of anterior teeth. Artificial teeth in the form of porcelain crowns are fitted onto the implants. Gum tissue modification or bone grafting is not necessary per this protocol. There are also other types of crowns including zirconium used for this treatment. The dentist had informed parents that they needed to get this done at a specialty dental implant hospital. He had then referred the patient to us for further management. Our hospital is a specialty center for dental implant placement. We are amongst the first centers in the city to offer successful graftless implant rehabilitation using zygoma implant surgery. Over 25000 patients have been successfully rehabilitated in our hospital with premium quality dental implants in the last decade. Implant-supported dental crowns are fabricated in our state of art in-house dental laboratory. Dental professionals trained in quality control procedures oversee the entire process. These permanent crowns are fixed over dental implants to offer permanent rehabilitation. Dental cement and luting agents used are of the highest quality thus ensuring very high long-term survival rates. We also place temporary crowns over the dental implants during the fabrication process of the permanent crowns. Initial presentation for fractured tooth extraction and dental implant placement Dr. SM Balaji, dental implant surgeon, examined the patient and obtained imaging studies. These revealed the horizontal root fracture in the middle third region of the tooth. He explained the treatment plan to the patient and his parents who readily consented to the procedure. After administration of local anesthetic, the coronal portion of the fractured tooth was extracted with the extruding root canal obturation material. An endodontic file was then carefully threaded through the broken apical fragment, which was carefully removed without any trauma to the socket. Following the successful removal of the fractured tooth, a Nobel Biocare implant was carefully placed into the extraction socket. The flap was then closed with sutures. Dental implant osseointegration to the socket would take approximately four months. The patient was instructed to return in four months for placement of a ceramic crown on the implant. The patient and his parents expressed understanding of the instructions and will return for ceramic crown fixation. Video – Dental Implant Surgery [/et_pb_text][et_pb_video src=”https://youtu.be/xQcOG0xe_6M” _builder_version=”4.9.2″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Read moreBroken Front Tooth Removal and Dental Implant Surgery[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] Facial Asymmetry Surgery by bilateral sagittal split osteotomy (BSSO) Patient with a Progressive Increase in Lower Jaw Size The patient is a 21-year-old male from Durgapur in West Bengal, India. He has always had a very large lower jaw in comparison to his upper jaw. There was also a slight deviation of the lower jaw to the right. This resulted in a mild asymmetry of his lower face. A bilateral sagittal split osteotomy (BSSO) is the surgery of choice for reducing a large lower jaw. A receded lower jaw is advanced using distraction osteogenesis. Internal distraction is safer and preferred over external distraction. The open bite caused by upper jaw abnormalities is corrected through maxillary osteotomy. Size discrepancy between the jaws can lead to a lot of functional difficulties. Speech is altered and eating patterns are also altered. Left unaddressed, this could possibly also lead to problems with the temporomandibular joint (TMJ). Cosmetic compromise is another important aspect that could lead to issues with self-esteem and self-confidence. Associated Difficulties Caused by his Jaw Asymmetry He has also faced speech and eating difficulties throughout his life. Of note, his brother also has a large lower jaw. He had presented to a surgeon in his hometown. Realizing that this was a complicated presentation, he was referred to us for surgery for jaw and chin correction. The mechanism behind Perception of Jaw Size Discrepancy The disparity in jaw size is a common cause of facial deformity and asymmetry. Either the lower jaw or the upper jaw can be larger than the other jaw. This could be a result of either a large jaw or a small jaw. A small upper jaw could make a normal lower jaw appear large. Correction of this deformity could either be through jaw reduction or jaw augmentation. Le Fort I maxillary setback reduces the size of a large upper jaw. Bilateral sagittal split osteotomy reduces the size of a large lower jaw. An increase in the size of the lower jaw is through distraction osteogenesis. Le Fort I osteotomy is the technique of choice for upper jaw advancement. Jaw reconstructive surgery helps correct a variety of deformities, both congenital and acquired. Facial plastic surgeons also perform these surgeries in Japan and other developed countries. Initial Presentation for Jaw Correction Surgery at our Hospital Dr. SM Balaji, facial asymmetry surgery specialist, examined the patient. The patient had mandibular prognathism as well as lower facial asymmetry. Treatment planning was formulated and explained to the patient. He was in agreement and consented to jaw reduction surgery. Specialty Surgical Procedures Performed at our Hospital Our hospital is a specialty center for facial cosmetic surgery. Facial plastic surgery in our hospital has transformed many lives. Scar revision surgery for burn scars is performed through tissue expansion. We are a specialty center for cosmetic nose surgery in India. Successful Surgical Correction of Jaw Deformity Bilateral bone cuts were first made in the mandible. The nerve was safely mobilized with the distal segment. This allowed for free manipulation of the proximal segment. Extreme care was taken to preserve the inferior alveolar nerve during surgery. A slice of bone 14mm in thickness was removed from the left side. This was followed by a smaller slice of 12 mm being removed from the right to set right the asymmetry. Occlusion was checked and was found to be normal. The mandible was then stabilized with plates and screws. His facial appearance was transformed following the surgery. He was very happy with the results of the surgery. His family thanked the surgical team before discharge from the hospital. 5 Points on Facial Asymmetry Surgery – Facial Cosmetic Surgery A Minor Degree of Facial Asymmetry is Completely Normal Both sides of the face are near mirror images though it is never a perfect match. There is a minor degree of facial asymmetry even in normal faces. This is how nature works. There is never perfect symmetry of the face or the body. It is this minor asymmetry that adds to the attractiveness of the individual. This asymmetry is however not evident to common people. Purely Cosmetic Deformity Versus Function Affecting Deformity It is only when this degree of asymmetry is present to a degree where it is clearly noticeable that it becomes a problem that needs to be addressed. There are two components to the problems caused by this. One is pure cosmetic where it is only the appearance that is affected and not the function. The second is when normal function is affected by the asymmetry. Procedures for Cosmetic Facial Asymmetry Correction Procedures like cosmetic rhinoplasty help correct minor imperfections in the face and enhance the appearance of the individual. Many high visibility celebrities undergo such procedures to enhance their facial features for greater career opportunities. Facial asymmetry normally manifests itself early in life whether it is idiopathic or caused by a medical condition like hemifacial microsomia. Injuries or infections to the developing baby during pregnancy can also result in facial disfigurement. It can however occur at any stage in life too as a result of trauma or diseases like cancer. Facial asymmetry is very distressing to the affected individual and leads to associated psychological effects like depression and becoming introverted with self-isolation. Struggles of Mankind through the Ages for Restoring Normal Facial Appearance Mankind has tried to address this over the ages through various means. For example, World War I was the first truly global war that led to unprecedented levels of facial mutilation. A special unit was created to help individuals who suffered from facial asymmetry due to injuries sustained in war. Facial Plastic Surgery developed rapidly through the efforts of such units. The Development of Modern Surgical Techniques Modern surgery has come a long way in addressing the issue of facial asymmetry. Oral and Maxillofacial Surgery as well as Craniofacial Surgery deal extensively with the correction of facial asymmetry and restoration of normal facial...
Read moreFacial Asymmetry Correction by BSSO Surgery[et_pb_section fb_built=”1″ admin_label=”section” _builder_version=”3.22″][et_pb_row admin_label=”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″] What is Bilateral Sagittal Split Osteotomy Reduction Orthognathic surgery is the surgical correction of the components of the facial skeleton in patients with dentofacial skeletal defects to restore the proper anatomical and functional relationship. The bilateral sagittal split osteotomy (BSSO), which is the most frequently performed jaw surgery, either with or without upper jaw surgery, is an important component of orthognathic surgery. Horizontal mandibular excess, deficiency, and/or asymmetry are indications for a bilateral sagittal split. It is the most widely used treatment for mandibular advancement and can also be used for a mild to moderate mandibular setback. Bilateral sagittal split osteotomy reduction is a required surgical technique for correcting mandibular deformities. Correcting these deformities necessitates a detailed understanding of the signs, procedures, and complications of the sagittal split osteotomy. Patient Troubled with a Large Lower Jaw The patient is a 21-year-old male from Palakkad in Kerala, India. His lower jaw has always been very large since he can remember. He has had eating and speech difficulties for a very long time now. There was also an element of bullying while he was in school. The size of his lower jaw also prevented him from obtaining a full lip seal. This led him to have drying of his oral mucosa with resultant bad breath. He has now secured a good job and wanted to get this corrected. He zeroed in on us after extensive Internet research and word-of-mouth inquiries. Specialty Center for Jaw Surgery Our hospital specializes in all varieties of jaw surgery. We perform jaw reconstruction surgery for many conditions. This includes jaw reduction and jaw augmentation surgery for both jaws. Orthognathic surgery using maxillary osteotomy results in the correction of maxillary defects. We perform jaw advancement surgery through distraction osteogenesis. Patients with obstructive sleep apnea get relief through this surgery. We use the latest intraoral distraction devices for this surgery. Complete patient satisfaction is a salient feature at our hospital. We are a specialty center for dental implant surgery. Plastic surgeons also perform these procedures in Western countries. Correction of craniofacial deformities in children is also performed in our hospital. Our hospital is a specialty center for pediatric general anesthesia. Initial Treatment Planning upon Presentation Dr. SM Balaji, Jaw Reconstruction Surgeon, spoke with him and examined him. The patient had mandibular prognathism. He had an overjet of 10 mm with resultant cosmetic and functional compromise. Inquiries revealed that a large lower jaw was present in several family members. Imaging studies were then obtained and the treatment plan explained. The patient was in agreement and consented to surgery. Esthetic Results from Successful Jaw Reduction Surgery He underwent bilateral sagittal split osteotomy for reduction of the lower jaw. The inferior alveolar nerve was first mobilized with the distal segment. The nerve was fully protected throughout the surgery. This allowed for free manipulation of the proximal segment. Bilateral bone slices 12 mm thick were then removed from the osteotomy sites. The mandible was then set back and stabilized with plates after checking occlusion. Successful Correction of Large Lower Jaw This resulted in complete correction of his mandibular prognathism. There was the transformation of his facial features following the surgery. He expressed complete satisfaction with the results and thanked the surgical team. Video of Lower Bilateral Sagittal Split Osteotomy Reduction [/et_pb_text][et_pb_video _builder_version=”4.9.2″ _module_preset=”default” src=”https://youtu.be/D3PoSzeI_Fs” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
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