Successful closure of Oroantral Fistula
This is a middle-aged patient from a small town in Jharkhand. He had undergone extraction of an upper back tooth in his hometown. This was about a year ago. The wound refused to heal for a very long time. Any fluid he drank drained from his nose. This alarmed him to a great extent. He visited a local dentist. The dentist explained that there was a communication between his mouth and nose. He further explained the patient needed a minor surgery for this. The patient was then referred to a local oral surgeon. A few months after the surgery, the patient still had the problem. It was then that he decided to turn to the Internet. Internet research for the best oral surgeon led the patient straight to our hospital. The patient presented to our hospital. Dr. SM Balaji examined the patient and diagnosed an oroantral fistula. He then advised closure of the same. The oroantral fistula was then closed using Ashley’s palatal flap technique. A positive suction test demonstrated successful closure of the fistula. The patient expressed his thankfulness before final discharge from the hospital.
Successful surgical correction of the upper lip and nose defect using Abbe flap
This patient is a 30 year old native of Shimla. He was born with a bilateral cleft lip and palate. The patient has undergone primary cleft lip and palate surgery elsewhere when he was as an infant. He complained about nongrowth of hair in the center of the lip(prolabial region). The patient now has a depressed dorsum of the nose. The nose is at an obtuse angle. The patient was very specific about his appearance. He said this caused him to lack self confidence Rhinoplasty nose deformity specialist Dr SM Balaji planned the surgery. He planned to correct both the nose and lip defects using open rhinoplasty and Abbe flap. The columella of the nose was constructed using prolabium. The raw surface of the upper lip was then corrected by using a switch flap. The base of the flap was then kept attached to the lower lip for retention of blood supply. Once blood supply has been re-established in the upper lip, the flap division was then done. The defective upper lip and nose now had a more natural and esthetic appearance. The patient was very satisfied with the results.
Primary lip repair for unilateral cleft lip & palate
This is a 3-month old baby girl from Jammu. She was born with a unilateral cleft lip & palate. Her parents brought her to our hospital for treatment. An Internet search pointed to our hospital as being the best center for cleft repair. Maxillofacial Surgeon Dr. SM Balaji examined the patient. He performed the primary cleft lip repair surgery using Modified Millard’s technique. Following surgery, the baby’s appearance became normal. The parents were very happy with the results as she hardly had any post-surgical scars. Cleft palate correction surgery will be at a later date.
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