Rhinoplasty and Abbe Flap Reconstruction – Cleft Nose Repair
The patient is a 21-year-old female from Ongole in Andhra Pradesh, India. She was born with a bilateral cleft lip, palate and alveolus defect. There was an oronasal communication through the roof of the mouth.
Lower Jaw Reconstruction with Rib Graft and Dental Implant
The patient involved in a head-on car crash while on a work trip The patient is a 26-year-old businessman from Pune in Maharashtra, India. About a year ago, he had driven down to a nearby city for work. While there, he was involved in a head on collision with another automobile. His head had impacted directly on the steering wheel resulting in extensive lower facial injury. He had not been wearing his seatbelt at the time of the accident. He suffered a fractured lower jaw along with fractured teeth in both jaws. An ambulance had been summoned and he was immediately shifted to a nearby hospital. Imaging studies obtained at the hospital revealed bilateral body of the mandible fractures near the premolar region. He had also suffered fractures to maxillary and mandibular anterior teeth. There were no injuries to his eye sockets and bone fractures to other facial structures. This type of injury is very common to unrestrained drivers. They can be life threatening and surgeons with special training are required to address these complex injuries. Complications of malunion and infection with resultant loss of alveolar bone An emergency surgery had been performed and his bilateral mandibular fractures had been stabilized with titanium plates. His fractured anterior teeth were also extracted. Within a month after surgery, it became evident that the surgery had been poorly performed. Bilateral fracture fixation sites developed an infection. This resulted in extensive resorption of the anterior alveolar bone. The height of the alveolus was greatly reduced. Referral to our hospital for management of complications of previous surgery The patient presented at a local hospital for management of his problem. Imaging studies were obtained. The patient was informed that he had suffered from extensive alveolar bone loss secondary to the infection. There was malunion of the fracture repair with infected plates. Postsurgical suturing had been performed poorly with resultant abnormal frenal attachments. The patient and his family were counseled extensively regarding this. It was explained to them that his problem needed to be addressed at a specialty facial trauma care hospital. They were then referred to our hospital for treatment. Anxiety of patient and his family allayed during initial consultation in our hospital Dr SM Balaji, facial trauma care surgeon, examined the patient and ordered imaging studies including a 3D CT scan. There was malunion of the fracture along with reduced alveolar height. This had been caused due to the infection at the fracture site. There was also extensive loss of anterior teeth in both the maxilla and the mandible. Treatment planning explained in detail to the patient and his family It was explained that the patient’s infected titanium plates needed to be removed. This would be followed by reconstruction of the alveolar bone using bone grafts harvested from the patient. Nobel Biocare dental implants would then be placed for rehabilitation of the missing upper anterior teeth. A period of six months would be allowed for bony consolidation of the graft to the alveolar bone. This would be followed by the placement of dental implants for rehabilitation of the missing lower anterior teeth. Ceramic crowns would be placed on the dental implants following complete osseointegration of the implants to the surrounding alveolar bone. The patient and his parents were in complete agreement with the treatment plan and consented to surgery. Successful completion of jaw reconstructive surgery for the patient Under general anesthesia, an inframammary incision was made and a rib graft was harvested. A Valsalva maneuver was then performed to ensure that there was no perforation into the thoracic cavity. Attention was turned to the maxilla where dental implants were placed in the anterior region. This was followed by a mandibular vestibular incision with the removal of the infected plates. The rib graft was then crafted to fit perfectly into the anterior alveolar defect. This was then fixed in place with screws and flaps closed with sutures. Patient expresses understanding of postoperative instructions The patient and his parents expressed their satisfaction with the treatment planning and the surgical results. They stated that they will return in six months for the complete rehabilitation of his oral structures. Surgery Video
Dentigerous Cyst Surgery with Lower Jaw Reconstruction
The patient is a 36-year-old man from Satna in Madhya Pradesh, India. He had developed pain and swelling in the molar region of his right lower jaw about six months ago.
Unilateral Cleft Deformity – Le Fort I Upper Jaw Advancement
The patient is a 19-year-old male from Thanjavur in Tamil Nadu, India. The product of a consanguineous marriage, he was born with a unilateral cleft lip, palate and alveolus deformity.
Mandibular Dental Implant Surgery with Alveolar Nerve Protection
The patient is a 48-year-old male from Sambalpur in Odisha, India. He has a very strong family history of diabetes on both the paternal and maternal sides of his family.
Malunited Zygomatic Complex Blowout Fracture Resurgery
The patient is a 32-year-old woman from Bengaluru in Karnataka, India. Around three years ago, she had been on her way to work as usual on her motor scooter.
Bilateral Sagittal Split Osteotomy – Mandibular Prognathism
The patient is a 22-year-old woman from Manimala in Kerala, India. She states that she always remembers having a large lower jaw. Her chin bone too was extremely prominent.
Le Fort I Advancement Surgery and Dental Implant Surgery
The patient is an 18-year-old male from Warangal in Telangana, India. He had been born with a bilateral cleft lip, palate and alveolus deformity
Jawline Correction – Mandibular Distraction for Sleep Apnea
The patient is a 25-year-old male from Haridwar in Uttarakhand, India. He states that he had always had a small lower half of face. Both his maxilla and his mandible were extremely retruded.
Jaw Reconstruction – Hemifacial Microsomia Correction
The patient is a 7-year-old female from Hastinapur in Uttar Pradesh, India. She had a minor degree of facial asymmetry at birth. This gradually worsened with age. It soon became apparent to her parents that there was an abnormality underlying her condition.