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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 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Evaluation of Morphological (Macroscopic and Microscopic) Parameters of Placentas in Pregnancies Complicated by Preeclampsia, Diabetes and Preeclampsia and Diabetes.
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This study was done to compare the morphometric parameters of placentas in well controlled patients with preeclampsia, diabetes, and preeclampsia-diabetes with that of normal uncomplicated placentas. Patients & Methods: A total of Twenty four placentas were freshly collected. Six placentas for control group and eighteen placentas for complicated group (preeclamptic-diabetic and preeclamptic--diabetic subgroups). The placentas were grossly examined (shape, number of cotyledons, weight, and thickness). After suitable fixation, tissue processing and sectioning, the sections were stained by hematoxylin and eosin to study the general morphology and morphometry of the following parameters: number of terminal villi, number of syncytial knots, numb

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Publication Date
Thu Dec 01 2022
Journal Name
Advances In Cancer Biology - Metastasis
CX3CL1 as potential immunotherapeutic tool for bone metastases in lung cancer: A preclinical study
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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of 2 different techniques in second stage implant surgery
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Background: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose. The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale . Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for th

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Publication Date
Tue Oct 04 2022
Journal Name
International Journal Of Dentistry
Comparison between Rolled and Nonrolled U-Shaped Flap in the Second Stage of Dental Implant Surgery: A Randomized Clinical Trial
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Background. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh

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Publication Date
Tue Mar 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of alveolar bone height in adolescents utilizing Cone Beam Computed Tomography: a retrospective radiographic analysis
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Background: To assess the alveolar bone crest level (ABCL) by Cone Beam Computed To-mography (CBCT) and to investigate several variables as predictors for the height of the alveolar bone in adolescents. Materials and methods: Age, sex, and ethnic groups were rec-orded for each patient. CBCT images were used to obtain measurements of the interproximal alveolar bone level from the cementoenamel junction (CEJ) to the alveolar crest. The highest measurement in each sextant was recorded along with any presence of a vertical bone defect or calculus. Results: Total of 720 measurements were recorded for 120 subjects. No vertical bony defects or calculus were observed radiographically. Statistically significant (P< 0.05) differences were observed be

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
The Effect of Leptin Level in Pregnancy Complicated by Intrauterine Growth Restriction on Neonatal Outcome, in an Iraqi Center
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Background: Fifteen percent of small for gestational age are small as a result of fetal growth restriction, which could be due to maternal, placental or fetal factors. It is an important clinical problem associated with increase perinatal mortality and morbidity. Leptin is a protein that produced by many tissues including the placenta (syncytiotropholoast). Dysregulation of leptin metabolism may be implicated in preeclampsia and IUGR pathogenesis.
Aim of the study: To study the trend of leptin level alteration in maternal serum and cord blood in pregnancies complicated by fetal growth restriction and its relation with fetal outcome.
Methods: An Analytic, cross- sectional study conducted in Al-Elwyia Maternity Teaching Hospital and

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Preoperative Psycho-educational Program on Stress of Cardiac Surgery Patients
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Objective: The study aimed to determine the effectiveness of preoperative psycho - education al
program on cardiac surgery patients information and their level of stress. And find out the differences
in the Psycho educational
program with regard to patients demographic characteristics such as age and gender.
Methodology Aquazi-experimental study was carried out to determine the effectiveness of
preoperative education program on stress for cardiac surgery patients in Baghdad city from the 28th of
March, 2010 , to 19th of September ,2011.
The preoperative psycho - educational program, as well as the questionnaire was constructed as a tool of
data collection for the purpose of the study. Purposive (non probability) s

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Publication Date
Thu Mar 03 2022
Journal Name
Archives Of Rheumatology
Association of tumor necrosis factor-alpha promoter region gene polymorphism at positions -308G/A, -857C/T, and -863C/A with etanercept response in Iraqi rheumatoid arthritis patients
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Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept.

Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reac

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to comp

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Publication Date
Wed Jul 02 2014
Journal Name
Journal Of The Faculty Of Medicine
Unintended durotomy during degenerative lumbar Spine surgery (Incidence and management
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AW Tarik, AW Ali T, A Salah, Journal of faculity of medicine Baghdad university, 2014 - Cited by 3

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