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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
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Serum Vitamin D Levels in a Sample of Iraqi Female Patients
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Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosa diseases characterized by recurrent, shallow, round or oval painful oral ulcers surrounded by inflammatory erythematous halos, the condition is chronic and self-limiting in immunocompetent patients. Aim of the study: to investigate the serum vitamin D levels in Iraqi female patients with RAS and the relationship between vitamin D levels and the severity of RAS. In this cross sectional study 30 female patients with idiopathic RAS, and 30 age and sex matched healthy controls were included, the severity of RAS is assessed by the number of oral aphthous ulcers in each attack and the frequency of attacks. Serum 25(OH) D levels were determined by the Enzy

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
A stylistic study of proisepoeme and congratulation from Hafiz Ibrahim's collection
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A stylistic study in the poetry of Hafiz Ibrahim, praise be to God, Lord of the worlds, and prayers and peace be upon his best messengers, and the seal of his prophets, Muhammad and his good and pure family, and after ...
The poet Hafez Ibrahim is considered one of the well-known poets in the modern era, and his language was distinguished by sobriety, eloquence in expressions, and beautiful meanings And he had my journey in the study of his poetry a stylistic study, and the research came with an introduction in which the concept of stylistics was briefly explained, since it was studied by many researchers, then divided the research into three topics: I studied in the first the construction of the poem, and I stood at the most importan

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Physics: Conference Series
A CERTAIN SUBCLASS OF MULTIVALENT HARMONIC FUNCTIONS DEFINED BY RUSCHEWEYH DERIVATIVES
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Abstract<p>We introduce a new class of harmonici multivalent functions define by generalized Rucheweyh derivative operator. We also obtain several interesting propertiesi such as sharp coefficienit estimates, distortioni bound, extreme points, Hadamardi product and other several results. Derivative; extreme points.</p>
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Publication Date
Thu Jan 10 2019
Journal Name
Association Of Arab Universities Journal Of Engineering
Improvement of Earth Canals Constructed on a Gypseous Soil By Cement
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Publication Date
Fri Mar 25 2022
Journal Name
Nasaq Journal
A Linguistic Study of Paronomasia (Al-Jinās ) in Arabic and English
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Paronomasia is a recognized rhetorical device by which poets could play with words that are similar or identical in form but different in meaning. The present study aims to identify paronomasia in Arabic and English. To achieve the aim of the study, a corpus of selected verses chosen from two famous figures in Arabic and English literatures and analyzed thoroughly. The analysis of data under investigation reveals that paronomasia is a crucial aid used by poets to portrait the real world as imaginative. It further shows that the concept of paronomasia in English is not the same as in Arabic. In English, there are echoes of the Arabic jinās, i.e., there are counterpart usages of similar devices, yet English rhetoricians have not defined or c

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Publication Date
Mon Jan 18 2016
Journal Name
Publications Of The Astronomical Society Of The Pacific
Extreme Contrast Ratio Imaging of Sirius with a Charge Injection Device
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Publication Date
Sat Apr 09 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Static Shear Strength of a Non-Prismatic Beam with Transverse Openings
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In this study, a predicated formula is been proposed to find the shear strength of non-prismatic beams with or without openings. It depends on the contributions of concrete shear strength considering the beam depth variation and existing openings, shear steel reinforcements and defines the critical shear section, the effect of diagonal shear reinforcement, the effect of inclined tensile steel reinforcement, and the compression chord influence. The verification of the proposed formula has been conducted on the experimental test results of 26 non-prismatic beams with or without openings at the same loading conditions. The results reflect that the predicted formula finds the shear capacity of non-prismatic beams with openings, it is co

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Publication Date
Sun Feb 22 2026
Journal Name
Al–bahith Al–a'alami
Organizational reputation: A descriptive study of concept development and measurement techniques
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The study aimed to monitor the concept of reputation in the previous literature, its relationship to mental image and identity, and to reveal recent trends in its measurement Techniques.

    The study relied on a descriptive approach using library survey and comparative analysis, and the study reached following conclusions:

     Despite the beginning of the first signs of reputation In the fifties of the last century, however, Defining and standardizing the concept with clear and specific dimensions began in the 1990s and the beginning of the third millennium. The concept of reputation refers to the stakeholders’ overall evaluation of organizations, which reflects their perceptions of

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Publication Date
Thu Jan 02 2025
Journal Name
Journal Of Advanced Pharmacy Education And Research
Review of interleukin-6 polymorphisms in rheumatoid arthritis: a genetic implications
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The objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of The College Of Languages (jcl)
A Critical Discourse Analysis of the 2012 American Presidential Election Debates
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This study discusses the Critical Discourse Analysis of 2012 American Presidential Election Debate’. The researcher adopts a model proposed by Van Dijk’s (2006 d). Six ideological categories have been selected within the overall strategies of the ideological square are used. The categories are of three levels of discourse structure : (the meaning, the argumentation, and the rhetoric) .They have shown effective criteria for detecting the most disguised systems of racism and manipulation.

            Based on the analysis, it can be concluded that the elite discourses of candidates contribute to the reproduction of domination, Orientalism, and Islamophobia. This can be appl

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