Anonymised cases. Real outcomes.

Presentation

Lifelong skeletal class III with a pronounced lower jaw, anterior crossbite affecting incision, and self-consciousness about facial profile. Two prior consultations had recommended only orthodontic camouflage.

Surgical approach

Combined Le Fort I maxillary advancement of 5 mm, bilateral sagittal split osteotomy with mandibular set-back of 4 mm, and a 3 mm advancement genioplasty. Virtual surgical planning generated 3D-printed splints with sub-millimetre accuracy.

Outcome at follow-up

Class I occlusion achieved in theatre. Patient reported immediate improvement in incising and chewing. Twelve-month follow-up shows stable bite, balanced profile and resolved TMJ symptoms.

Treatment timeline

1. 01Week 0Records & 3D planningCBCT, intra-oral scan and photographic series. Virtual surgical plan delivered with patient input.
2. 02Months 1–11Pre-surgical orthodonticsBite decompensation by referring orthodontist in Riyadh, monitored remotely.
3. 03Month 12SurgeryBimaxillary procedure with genioplasty, 4 hr 20 min theatre time, 2 nights inpatient.
4. 04Months 12–13RecoveryTwo-week soft diet, lymphatic drainage protocol. Patient flew home day 11.
5. 05Months 13–16Finishing & retentionThree months of orthodontic finishing, retainers issued at debond.

Presentation

Childhood trauma with untreated nasal fracture. Persistent right-sided nasal obstruction, audible whistle on exhalation, and a visible dorsal deviation. Two prior septoplasties had failed to resolve breathing.

Surgical approach

Open structural septorhinoplasty with extracorporeal septal reconstruction using septal cartilage and a small auricular conchal graft for tip support. Spreader grafts placed bilaterally to address internal valve collapse.

Outcome at follow-up

Symmetric airway restored on endoscopy. Patient reports normal breathing through both nares for the first time in his adult life. Aesthetic result: straight dorsum, refined tip, natural projection.

Treatment timeline

1. 01Week 0Consultation & endoscopyNasal endoscopy, photographic analysis, simulation discussion.
2. 02Week 2Surgery3 hr 15 min theatre. Extracorporeal septal reconstruction. Day-case discharge.
3. 03Weeks 2–3Splint weekExternal splint and internal silicone splints for 7 days. Patient flew home day 9.
4. 04Months 1–6HealingGradual resolution of swelling. Telehealth review at month 3 and month 6.
5. 05Month 1212-month reviewIn-clinic photography. Settled, durable result.

Presentation

Failing maxillary dentition with severe horizontal and vertical bone loss. Declined for conventional implants by two providers. Wearing an unstable upper denture for three years, unable to eat in public.

Surgical approach

Quad-zygoma protocol: four zygomatic implants placed bilaterally under intravenous sedation, bypassing the atrophic alveolus entirely. Fixed provisional bridge delivered the same evening.

Outcome at follow-up

Patient ate solid food the following day. Definitive zirconia bridge delivered at month 5. At 24-month follow-up, all four implants are stable and the patient reports complete return of chewing function.

Treatment timeline

1. 01Week 03D planningCBCT, intra-oral scan, prosthetic wax-up. Surgical guide manufactured in-house.
2. 02Week 3Surgery & provisional2 hr 45 min theatre time under IV sedation. Fixed provisional bridge delivered same evening.
3. 03Weeks 3–6Healing & soft dietTwo-week soft diet, gradual progression. Patient flew home day 5.
4. 04Month 3Hygiene reviewSoft tissue maturation, occlusion check.
5. 05Month 5Definitive bridgeFinal zirconia hybrid bridge delivered with prosthodontist.

Presentation

Eighteen-month history of right TMJ pain progressing to closed lock. Mouth opening reduced to 22 mm. Failed conservative care including splint, physiotherapy and corticosteroid injection elsewhere.

Surgical approach

Right TMJ arthroscopy with lysis of adhesions, lavage of the upper joint space and posterior disc release. 35-minute day-case procedure under general anaesthesia.

Outcome at follow-up

Mouth opening immediately increased to 38 mm in recovery. At three-month review, comfortable opening of 44 mm with resolved pain. Patient returned to a normal diet within two weeks.

Treatment timeline

1. 01Week 0Imaging & assessmentMRI confirming anterior disc displacement without reduction. Failed conservative pathway documented.
2. 02Week 1ArthroscopyDay-case keyhole procedure, discharged same evening.
3. 03Weeks 1–2Early rehabSoft diet, structured opening exercises with physiotherapist.
4. 04Week 6Function reviewSymmetric opening, pain-free function.
5. 05Month 33-month reviewStable result, splint discontinued.