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Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery
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Study Design

Case Report.

Objective

To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.

Method

A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage.

Results

On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship.

Conclusion

Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Tuberculin as Intralesional Therapy for Viral Warts—Single-Blind, Split, Placebo, Controlled Study
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Publication Date
Thu Jan 21 2010
Journal Name
Iraqi Journal Of Veterinary Medicine
Production and Partial Purification of Heat-Stable Enterotoxin (A) Produced by Enterotoxigenic Escherichia coli
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A total of (25) stool samples were collected from children and adults (2- 4) years old suffering from diarrhea to isolate E. coli strains that produce heat-stable enterotoxin a (STa), and after performing microscopic examination, cultural characterization and biochemical identification only (11) isolates showed positive E. coli. STa activity was estimated by using suckling mouse assay (SMA) and from these (11) isolates only (5) showed STa activity and the one with the highest STa activity was selected for large scale production of STa, which was followed by partial purification using ion-exchange chromatography (normal phase) using DEAE sephadex A-50 column. After purification and determination of protein concentration by using the standard

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Roughness Effect on Thermo-Elasto-Hydrodynamic Performance of a 170áµ’ -Arc Partial Journal Bearing
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In the current analysis, the effects of circumferential scratches along the inner surface of a 170ᵒ -arc partial journal bearing has been numerically investigated. Their impact on the thermo-elasto-hydrodynamic performance characteristics, including maximum pressure, temperature, deformation, and stress, has been examined thoroughly. The ANSYS Fluent CFD commercial code was employed to tackle the iterative solution of flow and heat transfer patterns in the fluid film domain. They are then applied to the ANSYS Static Structure solver to compute the deformation and stress resulted in the solid bearing zone. A wide range of operating conditions has been considered, including the eccentricity ratio ( ) and scratch depth (

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
An Analysis of a Partial Temporary Immunity SIR Epidemic Model with Nonlinear Treatment Rate
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     A partial temporary immunity SIR epidemic model involv nonlinear treatment rate is proposed and studied. The basic reproduction number  is determined. The local and global stability of all equilibria of the model are analyzed. The conditions for occurrence of local bifurcation in the proposed epidemic model are established. Finally, numerical simulation is used to confirm our obtained analytical results and specify the control set of parameters that affect the dynamics of the model.

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Clinical And Experimental Dentistry
The effect of osseodensification on implant stability and bone density: A prospective observational study
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Background: The aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Material and methods: This prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was conside

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
IGG and IGM response in a group of Iraqi health care worker following SARS-CoV-2 mRNA vaccine
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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
Stress Analysis of the Hip Bone
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The bony pelvis has a major role in weight transmission to the lower limbs. The complexities of its geometric form, material properties, and loading conditions render it an open subject to biomechanical analysis.

 The present study deals with area measurement, and three-dimensional finite element analysis of the hip bone to investigate magnitudes, load direction, and stress distribution under physiological loading conditions.

 The surface areas of the auricular surface, lunate surface, and symphysis pubis were measured in (35) adult hip bones. A solid model was translated into ANSYS parametric design language to be analyzed by finite element analysis method under different loading conditions.

The surface

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Harmonic Knife New Haemostatic Procedure In Thyroid Surgery
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Background: Thyroid operation needs very meticulous haemostasis to have minimal morbidity and mortality.

Objectives: Assessment of harmonic knife in open thyroid surgery as anew haemostatic procedure .

Type of the study: Cross-sectional study.

Methods: This study had been conducted at Alkindy teaching hospital in Baghdad city from the 1st of May 2013 to the 1st of January 2017  on 229  goiterous patients who needs thyroidectomy(36 males,193 females),divided in 2 groups according to the haemostatic procedure used during their operations, Group A (15 males,85females)using the usual conventional surgery(

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Publication Date
Sat Oct 05 2019
Journal Name
Pediatric Cardiology
Personalised Warfarin Dosing in Children Post-cardiac Surgery
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Abstract<p>Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy a</p> ... Show More
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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Acute Appendicitis and Multisystemic Inflammatory Syndrome due to COVID-19: a Case Report and Literature Review
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

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