Broken 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”] 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]
Facial Asymmetry Correction by BSSO 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
Lower Jaw Protrusion – Bilateral Sagittal Split Osteotomy Reduction
[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]
OPEN VS CLOSED RHINOPLASTY WHICH TECHNIQUE IS BEST?
[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″] OPEN VS CLOSED RHINOPLASTY : WHICH TECHNIQUE IS BEST? RHINOPLASTY AS A LIFESTYLE CHOICE TO ENHANCE QUALITY OF LIFE Open vs Closed Rhinoplasty: Undergoing a nose correction surgery or a nose job is often a life-changing experience for an individual. A rhinoplasty can change a person’s life for the better or the worse. Many show-biz celebrities from around the world have seen their careers soar or collapse as a result of a rhinoplasty. NEED FOR EXTENSIVE PRESURGICAL COUNSELING REGARDING EXPECTATIONS Individuals who present for a cosmetic rhinoplasty have certain expectations about the results. It is imperative that they discuss these expectations in detail with the surgeon during the treatment planning phase itself. TYPES OF RHINOPLASTY FOR NASAL DEFORMITY CORRECTION There are two types of rhinoplasty procedures, namely open rhinoplasty and closed rhinoplasty. Open rhinoplasty involves making an incision in the soft tissue between the two nostrils. This allows for easy access to the bony and the cartilaginous parts of the nose. Closed rhinoplasty involves making incisions inside the nose. INDICATIONS FOR CLOSED AND OPEN RHINOPLASTY Extreme deformities of the nose are addressed through open rhinoplasty. An open rhinoplasty allows for greater manipulation of the structures that give form to the nose. Lesser deformities of the nose are addressed through closed rhinoplasty. There is minor visible scarring from an open rhinoplasty. There is no scar formation in a closed rhinoplasty as all incisions are made inside the nose. The recovery period is longer in open rhinoplasty with more postoperative swelling when compared to closed rhinoplasty. This is due to the greater degree of corrections performed through open rhinoplasty. IMPORTANCE OF EXPERIENCE OF SURGEON IN COSMETIC NOSE SURGERY Certain cases that have a complicated presentation can be addressed only through open rhinoplasty. Closed rhinoplasty cannot be performed for the correction of deformities in these cases; however, a vast majority of nasal deformities can be set right through closed rhinoplasty. Surgeons with greater experience can correct even large deformities through a closed rhinoplasty while these corrections are approached through an open rhinoplasty by lesser experienced surgeons. The average cost for open rhinoplasty is Rs 2,00, 000 and the average cost for closed rhinoplasty is Rs 1,50, 000. [/et_pb_text][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” hover_enabled=”0″ sticky_enabled=”0″] Closed Rhinoplasty with Nasal Augmentation – Cleft Lip Deformity Patient born with a unilateral cleft lip and palate deformity The patient is a 20-year-old female from Palakkad in Kerala, India. She had been born with a right-sided cleft lip and palate deformity. Her parents had been extensively counseled on the management of an infant with a cleft deformity. They had been referred to a nearby city for surgical management of her cleft deformity. She had subsequently undergone cleft lip repair at 3 months of age and cleft palate repair at 11 months. A plastic surgeon had performed these surgeries. The patient had subsequently developed speech difficulties for which she had undergone pharyngoplasty. Bone graft surgery is needed if there is a large cleft alveolus deformity. Worsening nasal defects with the passage of time As the patient grew up, her nasal deformities worsened. She had a nose that was flattened and asymmetrical. This was a direct result of the collapse of her columella. Her right alar region was also depressed due to a bony defect. Cleft nasal deformities involve both bone and cartilage. They are the most common form of birth defects. There was prominent scarring from the cleft lip repair surgery. The patient felt that this detracted from her facial esthetics. It was explained to her that a scar revision surgery can be scheduled at a later date to address that. Surgery for correcting her nasal deformities done elsewhere The patient had first undergone cosmetic rhinoplasty (nose job) at the age of 14. This was to correct her severely depressed nose, which was also asymmetrical. Multiple cartilage grafts had been harvested and used in this corrective surgery. She had however not been happy with the end results of the surgery. A couple of years later, she had undergone a redo rhinoplasty at a different hospital. The old grafts had been removed and replaced with new grafts. This had however worsened the appearance of her nose. She does not require open rhinoplasty. Her nasal deviation had become worse and she developed a whistling sound while breathing. Her alar base depression had not been addressed by either surgery. The patient feeling despondent and depressed as a result of the two failed surgeries Feeling extremely upset by the turn of events, she had slowly become depressed and withdrawn. Her academic performance had also become affected by this. Always a good student, she had become indifferent towards her studies. Alarmed by this, her parents decided to get this addressed to the patient’s satisfaction. Her parents made widespread enquiries and visited a score of surgical centers over the ensuing months. They got in touch with our hospital manager and sent the patient’s photographs for analysis. Convinced that our hospital was the ideal place for this surgery, they decided to come for a consultation. Premier center for cosmetic rhinoplasty and cleft rhinoplasty correction We have been addressing patients with nasal deformities for three decades now. Every variety of nasal deformity correction is performed at our hospital. Our hospital is world renowned for cleft rhinoplasty correction. We have won accolades from the International Cleft Lip and Palate Foundation of Japan. The World Craniofacial Foundation of USA has made us its Southeast Asian regional affiliate. Initial presentation at our hospital for detailed consultation and treatment planning Dr. SM Balaji, nasal cosmetic surgeon, examined the patient and obtained a detailed history and imaging studies. The patient-related her dissatisfaction with the results of the two previous surgeries. She had a severely depressed nose that was asymmetrical. There was resorption of the grafts that had been previously placed for nasal augmentation. The patient’s nose also had extensive transcolummelar intranasal scar formation from
Dental Implant vs Bridge
[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” text_font_size=”16px”] Missing teeth may lead to additional dental issues, but implants and bridges can restore your smile and enhance your dental and overall health. What is Dental implant? The dental implant is a surgical fixture that is inserted in the jawbone and allowed to attach with the bone for a few months. The dental implant is a substitute for the root of the missing tooth. In exchange, this “artificial tooth root” is used to carry a replacement tooth or bridge. Having a dental implant fused to the jawbone is the closest thing to imitating a natural tooth since it stands on its own without damaging the nearby teeth and has great stability. The process of fusion between the dental implant and the jawbone is called osseointegration. Most dental implants are made of titanium, which helps them to blend into the bone without being known as a foreign object in our body. Technology and research have evolved over time to significantly enhance the results of dental implant placement. Today, the success rate for dental implants is close to 98%. Dental implant Procedure An implant is normally the preferred choice for the replacement of a single tooth. Placing an implant requires careful planning to determine the amount of bone in which the implant is inserted to ensure that sufficient support for the implanted tooth is provided. We may take Cone Beam CT scan(CBCT) of your teeth to see the amount and shape of the bone available for the implant and to take impressions of your teeth. If your jawbone is sufficient, the dentist can use a computer to make models of your jaw to simulate the implant prior to the actual procedure. This will increase the precision of the insertion and minimise the amount of tissue disrupted during the implant process. If your jawbone does not accommodate an implant, we will increase it with bone or bone-like material during surgery. You’ll need to wait a few months for the bone to heal before you get an implant. The next move is to place the titanium screw which replaces the root of the tooth in your jaw. The screw is fitted with a cap that looks like a little stud in your gum. In the next few weeks, your jawbone will expand around the screw to anchor it securely in place, and your gum will heal. In the final step, the dentist will make sure that the implant is securely in place. He or she will remove the screw cap and replace it with a titanium abutment or a post. A porcelain crown designed to fit your surrounding teeth will be cemented or screwed onto the base. What is Dental Bridge? A bridge—which consists of artificial teeth fused to a metal frame—is a good way to replace a few teeth. The frame is cemented to support—either implants or healthy teeth protected by crowns. The more teeth are removed, the more natural teeth or implants are required to provide the bridge with the necessary support. Dental Bridge Procedure Having a bridge is a quicker procedure than getting an implant, but it also involves a number of visits; one for imaging and impressions, one for preparing crown teeth and fitting a temporary bridge, and another for fitting a permanent bridge. Dental implant vs. bridge Dental implants and bridges can theoretically produce natural-looking outcomes, but they do have their own advantages and disadvantages. Here’s a look at how these two tooth replacement choices are compared. [/et_pb_text][dsm_text_divider header=”The Advantages of Dental Implants over Dental Bridge” _builder_version=”4.9.2″ _module_preset=”default” header_font=”|700||on|||||”][/dsm_text_divider][et_pb_blurb use_icon=”on” font_icon=”%%190%%” icon_placement=”left” _builder_version=”4.9.2″ _module_preset=”default” body_font_size=”16px” background_enable_color=”off”] The initial cost of treatment is lower for dental bridges when compared to dental implants; however, the cost of dental implants works out to be cheaper over the long term than dental bridges if you take the following factors into consideration [/et_pb_blurb][et_pb_blurb use_icon=”on” font_icon=”%%190%%” icon_placement=”left” _builder_version=”4.9.2″ _module_preset=”default” body_font_size=”16px” background_enable_color=”off”] Tooth preparation for bridge placement involves mutilation of teeth that will support the bridge (abutment teeth). Any mutilation of tooth structure leads to compromise in the structural integrity of the tooth. Dental implants are very similar to normal teeth to the extent of even mimicking their root structure. They do not require any form of preparation of adjacent teeth. [/et_pb_blurb][et_pb_blurb use_icon=”on” font_icon=”%%190%%” icon_placement=”left” _builder_version=”4.9.2″ _module_preset=”default” body_font_size=”16px” background_enable_color=”off”] Secondary dental caries in abutment teeth is possible after several years in the case of bridges if oral hygiene is not scrupulously maintained at the bridge-abutment tooth interface. This could lead to loss of abutment teeth with the need to fabricate new dental bridges. Dental implants are stand alone units and are completely immune to problems such as caries that plague natural teeth; however, dental implants also require maintenance of meticulous oral hygiene as gum disease can lead to loss of bony support for the dental implant. [/et_pb_blurb][et_pb_blurb use_icon=”on” font_icon=”%%190%%” icon_placement=”left” _builder_version=”4.9.2″ _module_preset=”default” body_font_size=”16px” background_enable_color=”off”] Abutment teeth can also become mobile over the years due to excessive occlusal loads. This could again lead to loss of these teeth thus requiring new dental bridges. Dental implants are immensely strong and can bear occlusal loads that are equal to loads borne by natural teeth. [/et_pb_blurb][et_pb_blurb use_icon=”on” font_icon=”%%190%%” icon_placement=”left” _builder_version=”4.9.2″ _module_preset=”default” body_font_size=”16px” background_enable_color=”off”] Bridges may have to be replaced several times over the lifetime of the patient while dental implants offer a permanent solution for lost teeth. [/et_pb_blurb][/et_pb_column][/et_pb_row][/et_pb_section]
Bilateral Cleft Lip – Open Rhinoplasty
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ text_font_size=”16px” sticky_enabled=”0″] Open rhinoplasty cost in India The average cost for open rhinoplasty ranges from 75000 INR to 2,00, 000 Indian Rupees. This depends upon the complexity of the deformity. What is Open Rhinoplasty? Open rhinoplasty, also referred to as external rhinoplasty, is done by making a small incision on the columella, the soft tissue that divides the nose. When under general anaesthesia or twilight sedation, this procedure provides clear access to the underlying bone and cartilage structure. The primary advantage of the open technique is the increased precision for reshaping the nose frame to achieve the desired contouring. The accessible technique is better used when contemplating the revision of the rhinoplasty since the original structure of the nose has already been disrupted. Dr. SM Balaji can also use an open technique when the patient’s nose is crooked or when the nasal tip projection is significantly reduced (how far the tip sticks out from the face). The open rhinoplasty approach allows for a clearer view of the changes that need to be made, as well as precision and ease of intricate suture and/or grafting. The scar left behind is barely visible and usually disappears over time. Patient Undergoes Cleft Lip and Palate Surgery as an Infant The patient is a 19-year-old woman from Ballari in Karnataka, India. She was born with a cleft lip and palate deformity. Her parents had presented to a surgeon in their hometown for corrective surgery. There had always been excessive scarring at the site of surgical repair. Excessive Scar Formation at the Site of Surgery The deformity had worsened as she grew older. She had faced considerable bullying while in school and college. These difficult circumstances had made her an introvert. She had very few friends. There is also an issue of a lack of confidence because of these deformities. The hole in the roof of the mouth had been corrected at the time of initial surgery. Plastic surgeons also perform cleft repair surgery in Western nations. Oral and maxillofacial surgeons also perform facial cosmetic surgery. Parents Seek Out Best Hospital for Facial Deformity Surgery It had now worsened to the point where she refuses to leave the house. Her distraught parents decided to get this addressed and consulted family and friends. They conducted exhaustive Internet research to zero in on the best treatment available. Their search led them to our hospital. They contacted our hospital manager and fixed an appointment for a consultation. Specialty Center for Facial Cosmetic Surgery in India Our hospital is a premiere center for facial plastic surgery in India. We specialize in correcting deformities associated with cleft lip and palate defects. We are the regional affiliate of the US-based World Craniofacial Foundation. Orthognathic surgery also results in cosmetic improvement of the face. Patients from around the world undergo full rehabilitation of craniofacial defects with us. We are a leading center for cleft lip surgery and cleft palate surgery. Initial Examination and Treatment Planning at our Hospital Dr. SM Balaji examined her and obtained a detailed history. She had severe scarring of the prolabium. There was an obtuse nasal tip along with an absence of the columella. Her alar base was very broad. Treatment planning included the creation of a columella using prolabial tissue. The resultant prolabial defect would be then reconstructed using a flap from the lower lip. He spent time counseling the patient and her parents about what to expect from surgery. It was explained to them that this was a two-step surgery. They were in agreement with the treatment plan and she consented to undergo surgery. Recreation of Collapsed Columella through Open Rhinoplasty Markings were first made for a lower lip Abbe flap. A prolabial flap was then raised. An open rhinoplasty was next performed followed by osteotomy of the nasal bone and rearrangement of nasal cartilages. The prolabial tissue was used to recreate the collapsed columella. Abbe Flap Reconstruction for Prolabial Defect Attention was next turned to reconstruction of the prolabial defect. A flap of tissue with skin, muscle and intact blood supply was raised from the lower lip. This was next rotated and sutured to the prolabial defect in the upper lip. Care was taken to ensure that there was a patent blood supply to the flap. The lower lip donor site was then sutured. The lower lip flap remained attached to the upper lip for three weeks. The pedicle was then separated after blood supply has been established from the upper lip. She and her parents were very pleased with the results of the surgery. There was a tremendous improvement in her facial esthetics. They expressed that she would gain increased levels of self-confidence to face life again. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/bz_cLDQgDPE” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Distractor Removal after Le Fort III Bone Consolidation
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] What is Maxillary distraction osteogenesis? Maxillary distraction osteogenesis is a surgical technique that prolongs the lower jaw and forces the tongue forward to widen the airway and corrects these problems. Traditionally, babies with this disorder have been treated by tracheostomy, which continues for many years before the infant develops the condition. Patient born with the classical presentation of Crouzon syndrome deformities The patient is a 24-year-old female from Manapparai in Tamil Nadu, India. She was born with the abnormal facial features of Crouzon syndrome. Genetic testing is done soon after birth confirmed the diagnosis. Crouzon syndrome is caused by a genetic defect that leads to craniostenosis. There is the premature fusion of skull bones in this condition. This leads to the development of deformities of the face and skull. Manifestation of Crouzon syndrome with bony orbital and midfacial deformities This patient had most of the classical signs of Crouzon syndrome. She had protuberant eyeballs because of deficiency of the orbital bones. There was also a marked regression of the midfacial region. Strabismus was another classical sign that was seen in this patient along with a beaked nose. Difficulty childhood due to the extreme degree of facial defects in the patient She had faced a significant degree of bullying at school. Her parents had therefore decided to homeschool her for a majority of her school years. This limited social contact had resulted in her having very few friends. She had always been socially withdrawn and introverted. Her parents were counseled by a plastic surgeon that she needed surgical correction of her deformities. They had made extensive enquiries regarding the best hospital to address her needs. A social organization that helps patients with facial deformities had referred them to us. Premier center for craniofacial deformity correction in India Our hospital is a renowned center for facial deformity surgery in India. We deal with deformities that are both congenital and acquired in nature. Our center is a specialty center for facial trauma surgery in India. Only a few surgeons in India have the experience required to perform complex craniofacial procedures. Many patients with congenital facial defects arising from syndromic craniostenosis have been successfully treated in our hospital. Distraction surgery is routinely performed here. Facial bones are brought into perfect alignment through craniofacial surgery. Initial presentation for of syndromic facial deformity surgery in our hospital Dr. SM Balaji, syndromic craniofacial deformity surgeon, examined the patient. Imaging studies including 3D CT scans were ordered for the patient. He also obtained a 3D stereolithographic model of the patient’s skull. She had all the classical signs including protruding eyeballs, a beaked nose and midfacial retrusion. He explained that the patient needed midfacial Le Fort III advancement surgery along with internal distraction. A Kawamoto distractor device would be utilized for this. This was due to the extreme degree of midfacial retrusion. The patient subsequently underwent surgical correction of her deformities. A bicoronal flap was raised followed by bony cuts to the zygoma. The lower part of the orbital bone was then cut for 180 degrees next. This allowed for dysfunction of the bone. Kawamoto distractors were then fixed and checked with trial distraction. Her frontal prominence was also reduced through the use of a burr. The bicoronal flaps were closed. Maxillary Distraction osteogenesis commenced after the latency period. A total of 15 mm of distraction was performed. There was a complete correction of her midfacial retrusion along with strabismus. This would normalize her eyesight. Total patient satisfaction with the results of the surgery They were ecstatic with the results of the surgery. She could see things clearly now and there was a marked improvement in facial esthetics. Her parents were instructed to bring her back in four months for internal distractor removal surgery. This period would allow for bony consolidation at the site of distraction. Patient returns for removal of internal distractors after four months The patient and her parents returned for distractor removal surgery. After obtaining imaging studies, the patient was scheduled for distractor surgery. A bicoronal flap was raised and the distractor was removed by unscrewing the screws. Flap was closed using skin staples. Her skin staples were removed following the complete healing of the incision wound. They were instructed to return in four month’s time for a checkup. She and her parents expressed their complete satisfaction with the results. They thanked the surgical team before discharge from the hospital. [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false”] Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/mI1QSubWcTI” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Jaw Joint Fracture – TMJ Surgery
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] What is Jaw Joint Fracture (Temporomandibular Joint (TMJ) fracture) Jaw Joint Fracture or temporomandibular joint (TMJ) factor occurs when the mandible and/or temporal bone is broken near or through the TMJ, the joint linking the jaw bone to the skull. Like other bones in the body, the mandible, also known as the jaw bone, and the temporal bone, the bone on the skull that forms the upper part of the jaw joint, can break when trauma occurs. Fractures of TMJ arise due to direct trauma to the face. The jaw splits most frequently around the condyles, which are rounded projections of the jaw bone. The fracture can also occur when the joints are dislocated. Young Boy suffers Jaw Injury from Fall at Home The patient is an 11-year-old boy from Chennai in Tamil Nadu, India. He tripped and fell while playing with friends a few hours ago. His lower jaw hit the ground and he complained of inability to open his mouth fully. There was also mild bleeding from a lower lip laceration. His parents noticed a deviation of his jaw to the left side upon mouth opening. There was also a grating noise from the left jaw joint. He also complained of facial pain on the left side. There was radiation of pain from his jaw joint to the rest of the face. Development of facial asymmetry is a feature found in all fractures of the jaws. Movement of the jaw results in worsening of the pain. Initial Consultation at our Hospital for Management Fearing that he had a fracture, his parents rushed him to our hospital. Our hospital is a leading center for jaw fracture surgery in India. We are a specialty treatment center for jaw joint fractures. Our hospital has introduced various innovations related to jaw surgery. These innovations are standard operating procedures in many parts of the world today. Features of Jaw Surgeries Performed at our Hospital. Various conditions of the jaws are addressed at our hospital. Jaw reduction surgery and jaw augmentation surgery are also performed at our hospital. Upper jaw augmentation is commonly through Le Fort I maxillary osteotomy. Lower jaw augmentation is through distraction osteogenesis. Jaw reconstruction is also performed for lesions like tumors and cysts. Our hospital specializes in all types of TMJ surgery. Bone grafts harvested from the patient aid in the reconstruction of jaw deformities. These are most commonly harvested from the ribs and iliac crest. All these surgeries are performed under general anesthesia. Joint reduction surgery is performed after ensuring all safety precautions. Special safety features have been added in view of the COVID-19 pandemic. Lower jaw fractures are amongst the most common fractures. Common causes are accidents and assaults. The lower jaw most commonly strikes the ground first when there is a fall. Upper jaw fractures are more associated with assaults and road traffic accidents. They rarely occur from falls. Children constitute a high proportion of patients with jaw fractures. This is due to their very active lifestyle and physical activity. Forces are transmitted from the chin to the jaw joint. The chin and the jaw joint are the most common sites for lower jaw fracture. This can be treated by either open reduction or closed reduction. Closed reduction is utilized in children and in the case of favorable fractures. Open reduction is the preferred choice of treatment in more complex presentations. Examination and Treatment Planning for the Patient Dr. SM Balaji, facial cosmetic surgeon, examined the patient and obtained imaging studies. Lower lip laceration was sutured and a diagnosis of left temporomandibular joint condylar fracture was made. There was a medial displacement of the fractured condyle. This presentation necessitated plate fixation for fracture stabilization. Treatment planning was explained to the parents and they consented to surgery. Successful Reduction and Fixation of Condylar Fracture The fracture site was approached through a modified Alkayat-Bramley incision using an endaural approach. The fractured condylar segment was visualized and stabilized using plate and screws. Extreme care was taken to ensure the safety of the facial nerve. There will be no visible scar tissue from the surgery. Movement of the mandible after plate fixation demonstrated good fracture reduction. The patient recovered without an event from the surgery. He demonstrated good facial nerve function and there were no deficits. He opened his eyes and closed them forcefully as well as demonstrated normal mouth opening. They were very happy with the level of care at our hospital and expressed total satisfaction. He and his parents thanked the hospital staff before final discharge from the hospital. [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″ custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”] Surgery Video – Jaw Joint Fracture Surgery [/et_pb_text][et_pb_video _builder_version=”4.9.0″ _module_preset=”default” src=”https://youtu.be/Cygn5VtxmbQ” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
5 Important Points you should know about Jaw Reconstruction Surgery
[et_pb_section fb_built=”1″ _builder_version=”3.22″][et_pb_row _builder_version=”4.9.0″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.9.0″ text_font_size=”16px” background_size=”initial” background_position=”top_left” background_repeat=”repeat”] Jaw Reconstruction Surgery cost in India Jaw reconstruction, otherwise known as orthognathic surgery, is a procedure for correcting or adjusting any kind of jaw abnormalities. In certain cases, problems with the bite or alignment of the teeth may be corrected using jaw correction techniques of dental and orthodontic care. This is a specialized method of correcting any structural defects of the jaw. There are a number of ways in which such defects can occur; automobile accidents are the most common. Jaw repair is a technique used to address jaw disorders such as open bites, trouble chewing, difficulty swallowing, temporomandibular joint (TMJ) pain disorder, severe wear of teeth in the jaw, and receding chins. It can also be used to address serious orthodontic issues affecting the relationship between the teeth and the jaws, including the correction of under-bites and congenital abnormalities related to the formation of the jaw. It may also help to relieve sleep apnea, a potentially life-threatening disease. [/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”][et_pb_column type=”1_2″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_image src=”https://smbalaji.com//wp-content/uploads/2018/11/jaw-recosnstruction-surgery-india.png” alt=”best maxillofacial surgeon in india” title_text=”jaw-recosnstruction-surgery-india” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_image][/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_image src=”https://smbalaji.com/wp-content/uploads/2018/03/Lower-Jaw-Retrusion-before-after-picture.png” alt=”Lower Jaw Retrusion” title_text=”Lower Jaw Retrusion” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_image][/et_pb_column][/et_pb_row][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] 5 Important Points on Jaw Reconstruction [/et_pb_text][et_pb_accordion open_toggle_background_color=”#FFFFFF” closed_toggle_text_color=”#FFFFFF” closed_toggle_background_color=”#0C71C3″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_accordion_item title=”What is Jaw Reconstruction Surgery?” open=”on” _builder_version=”4.9.0″ _module_preset=”default”] Jaw reconstruction surgery is performed for the correction of jaw deformities. It can either be for cosmetic reasons, improve function or correct a deformity arising from an underlying disease process. [/et_pb_accordion_item][et_pb_accordion_item title=”What are the various conditions of the jaws that can be corrected by jaw reconstruction surgery?” _builder_version=”4.9.0″ _module_preset=”default” open=”off”] Jaw deformities include excessive jaw size or bony deficiency of the jaws. These can either be idiopathic (without any underlying cause) or could be the result of an abnormality. Jaw reduction surgery is performed for the correction of excessive jaw size (maxillary and mandibular prognathism). Jaw augmentation surgery is performed when there is a bony deficiency. [/et_pb_accordion_item][et_pb_accordion_item title=”Which disease processes most commonly require jaw reconstruction surgery?” _builder_version=”4.9.0″ _module_preset=”default” open=”off”] Tumours, cysts, traumatic injuries and syndromic deformities of the jaws are the most common underlying conditions that lead to bony deficiency requiring reconstructive jaw surgery. [/et_pb_accordion_item][et_pb_accordion_item title=”What are the various technique and methods that are used for jaw reconstruction surgery?” _builder_version=”4.9.0″ _module_preset=”default” open=”off”] There are various surgical techniques that are utilized for jaw reconstruction. These include utilizing grafts, reconstruction plates and distraction osteogenesis. Grafts can range from those harvested from the patients themselves to biosynthetic materials. Distraction osteogenesis uses the principle of new bone generation to help lengthen deficient jawbone. [/et_pb_accordion_item][et_pb_accordion_item title=”Which surgeons are best qualified to obtain the optimal results from jaw reconstruction surgery?” _builder_version=”4.9.0″ _module_preset=”default” open=”off”] Experienced oral and maxillofacial surgeons who have dealt with a multitude of jaw deformities obtain the best functional and cosmetic results from these procedures. Jaw reconstruction truly transforms the quality of life of the patient. [/et_pb_accordion_item][/et_pb_accordion][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] Jaw reconstruction surgery cost in India Any cosmetic procedure is a significant investment. Having agreed to undergo orthognathic surgery, you might naturally ask, ‘How much is the cost of orthognathic surgery? The cost of surgery varies from patient to patient, depending on the extent of the reconstruction. In India, plastic surgery can be used at a fraction of the cost in other countries without compromising the standard of treatment. The cost of jaw surgery in India ranges from INR 50,000 to INR 3,000,000 depending on the complexity of the surgery to be performed. [/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]
Fronto orbital Complex Fracture Surgery (Eye level Correction)
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” text_font_size=”16px”] Patient Involved in Road Traffic Accident in his Hometown The patient is a 46-year-old man from Ajmer in Rajasthan, India. He had been injured in a multi-vehicle road accident around six months ago. There was a direct impact on the left side of his face from a vehicular bonnet. He had suffered multiple fractures to the bones of the left upper and middle face. Orbital blowout fractures are common in such accidents. There were also serious soft tissue injuries. Failed Surgery at a Multispecialty Hospital He had been rushed to a multispecialty hospital in a nearby town for emergent care and treatment. This had been followed by a series of surgeries to correct his deformities. All these surgeries failed and he was left with a gross left-sided facial deformity. There was also malocclusion from the failed surgeries. Feeling very frustrated, he had approached an organization for help to address this. Having referred patients to us before for facial cosmetic surgery, they sent him to us. They contacted our hospital manager and set up an appointment for him. Our hospital is a specialty center for redo facial trauma surgery of failed surgeries performed elsewhere. Board-certified plastic and reconstructive surgeons perform such complex surgeries in Western nations. We rehabilitate patients who need complex head and neck surgery Initial Presentation at our Hospital for Redo Facial Trauma Surgery Dr. SM Balaji, facial reconstruction surgeon, examined him and obtained a detailed history. A 3D CT scan revealed malunion of his facial fractures from botched surgery. There was malpositioning of the medial wall of orbit fracture. He also had malunion of his frontozygomatic and front orbital fractures. His left frontal bone had a depressed fracture. Extraocular muscle movement was hampered by the circumorbital fractures. Multiple Fractures of the Left Facial Region There was also a blowout fracture of the left floor of the orbit. This had resulted in the lowering of his left orbital contents in relation to the right. A poorly positioned mesh was visualized over his left frontal bone. Malunion of his zygomaticomaxillary fracture had resulted in severe malocclusion. His speech was also affected by his condition. It was explained to him that all the old plates needed to be removed. The malunited fractures had to be refractured and replated in the correct anatomical position. The patient was in agreement with the plan and consented to surgery. Refracture of Multiple Malunited Fractures from Previous Surgeries Access was gained to the left forehead fracture site through the old incision. Plates from previous surgeries were removed. There was a very poor reduction of the front orbital and frontozygomatic fractures. Resetting Fracture Segments in Correct Anatomical Position Fracture segments were aligned in normal anatomical positions. The old mesh was also removed. Granulation tissue was excised from the region and bone smoothened with a bur. The old plates from the zygomaticomaxillary fracture fixation were removed. Occlusion was adjusted and the fracture fragments were stabilized with plates. His old zygomatic arch fracture was also stabilized with plates and screws. It had been unstable after the previous surgery. This was then followed by a subciliary incision. Access was gained to the orbital floor blowout fracture site. Entrapped orbital contents were released. The medial wall of orbit fracture was addressed next. The detached canthal ligament was reattached with a Y-plate canthopexy. This resulted in a good correction of the fracture. Next, a titanium mesh with Medpor was used to repair the orbital floor fracture. This resulted in eye-level correction for the patient. A new mesh was then placed over the depressed frontal bone fracture. Total Patient Satisfaction with Results of Surgery The surgery resulted in improved facial esthetics as well as functional improvements. The patient tolerated the procedure well. He expressed his gratitude to the surgical team before discharge from the hospital. [/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] Surgery Video [/et_pb_text][et_pb_video _builder_version=”4.9.0″ _module_preset=”default” src=”https://youtu.be/J7GVkGLIuDQ” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]