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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
Mon Dec 25 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Spectrophotometric Determination of Cefixime Following Simple Diazotization and Coupling with ?-Naphthol
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Cefixime (CFX) was treated with sodium nitrite and hydrochloric acid for diazotization reaction followed by coupling with ?-Naphthol in alkaline medium to form, a yellow colored azo dye compound which exhibits maximum absorption (?max) at 412 nm where the concentration of (CFX) was determined spectrophotometrically. The optimum reaction conditions and other analytical parameters were evaluated. Beer’s law was obeyed in the concentration range of (1-20) ?g.mL-1 with a molar absorptivity of 34870.5 L.mol-1.cm-1. The limit of detection was found to be 0.1090 ?g.mL-1 and the Sandell's sensitivity value was 0.0130 ?g.cm-2. The proposed method could be successfully applied to

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study
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Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compa

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study
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Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and

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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
Sun Jun 30 2019
Journal Name
Journal Of Engineering
Energy, Exergy and Anergy Analysis of Vertical Split Air Conditioner Under experimental ON-OFF Cycling
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A time series analysis can help to observe the behavior of the system and specify the system faults. In addition, it also helps to explain the various energy flows in the system and further aid in reducing the thermodynamic losses. The intelligent supervisory LabVIEW software can monitor the incoming data from the system by using Arduino microcontroller and calculates the important parameters. Energy, exergy, and anergy analysis present in this paper to investigate the system performance as well as its components. To accomplish this, a 4-ton vertical split air conditioner based on vapor compression refrigeration cycle charged with refrigerant R-22 was modified for experimental analysis. The results showed that during 540

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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
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
Incidence of Toxoplasmosis in Psoriasis Patients and Possible Correlation with Tumor Necrosis Factor-α
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            Toxoplasma gondii is an opportunistic parasite in immune-compromised persons. The prevalence of toxoplasmosis in psoriasis patients is investigated. In addition, the treatment effect on psoriasis patients infected with toxoplasmosis through evaluating Tumor Necrosis Factor-α (TNF-α) cytokine levels is studied. Blood samples were collected from 130 individuals who involved 60 control samples and 70 samples with psoriasis. They attended Medical City Hospital in Baghdad province from October 2017 - February 2018. Then, the anti- T. gondii antibodies (IgM and IgG) and TNF- α in the sera were determined via the enzyme linked immune-sorbent assay. The highe

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Publication Date
Tue Aug 23 2022
Journal Name
Journal Of Craniofacial Surgery
Differences Between Impression Stone Pouring and Digital Pouring in Fully Guided Dental Implant Surgery: A Prospective Clinical Study
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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
Sat Sep 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Bacteriological Findings within Internal Implant Hole Following Flapless Implant Placement
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Back ground: Microbial penetration inside the implant's internal hole creates a bacterial reservoir that is related with an area of inflamed connective tissue opposite the fixture-abutment junction and this can affect the health of the peri-implant tissue. Aims of the study: Evaluate the types aerobic and anaerobic bacterial count-percentage and difference between Aerobic and Anaerobic microflora in the implant screw hole three months after implant placement. Monitor the periodontal health status of all patients, throughout the study. Material and methods: Study methodology; Eight partially edentulous patients received 20 dental implants and these implants done with flapless surgical procedure. All patients examined clinically to determined

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