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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 Apr 01 2016
Journal Name
Communications In Nonlinear Science And Numerical Simulation
Simultaneous determination of time and space-dependent coefficients in a parabolic equation
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
The Behavior of the Al-Kadhim Minaret during Earthquakes: A Virtual Study
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The study focuses on the causes of minaret tilting as well as possible solutions. The major aims of this study are to improve knowledge of historical tall structure stability and rehabilitation operations using the finite element approach to model the soil and minaret (PLAXIS 3D 2020), a platform for computational soil investigation and modeling. The numerical analysis aims to identify stresses, settlement, and deformation of the soil and minaret in various scenarios like Earthquakes, explosions, and winds. The simulation of the problem by the PLAXIS 3D revealed that the greatest lateral displacement computed at the Top Minaret is 5.5 cm, and the greatest vertical movement is calculated to be 3 cm. Seismic settlement is the effect of ear

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Publication Date
Fri Sep 29 2023
Journal Name
International Journal Of Applied Mechanics And Engineering
Fuzzy logic control of active suspension system equipped with a hydraulic actuator
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In this paper, the Active Suspension System (ASS) of road vehicles was investigated. In addition to the conventional stiffness and damper, the proposed ASS includes a fuzzy controller, a hydraulic actuator, and an LVDT position sensor. Furthermore, this paper presents a nonlinear model describing the operation of the hydraulic actuator as a part of the suspension system. Additionally, the detailed steps of the fuzzy controller design for such a system are introduced. A MATLAB/Simulink model was constructed to study the proposed ASS at different profiles of road irregularities. The results have shown that the proposed ASS has superior performance compared to the conventional Passive Suspension System (PSS), where the body displacemen

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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Approaches to the formation of a contemporary explanatory mindset: Critical inductive study
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The issue of the development of Qur'anic studies for the tasks, and the first thought of minds and multiple understandings, and the most precious ideas, and the alternatives were floated, and varied visions, especially as we live in an era exploding knowledge, and complicate secretions, and scramble his ideas, and to devise intellectual approaches To achieve the witnesses of civilization in the words of the Almighty (to be martyrs on the people) Surat Al - Baqarah / 143 attendance and participation in the achievement and a positive interaction with the participants of humanity and civilization in the light of the meaning (to know) rooms / 13.
Therefore, we must emerge from the one-dimensional view of the Koran to the complex mindset t

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Pharmacy Research
Design and in vitro characterization of bisacodyl as a hollow-type suppositories
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Application of Seed Mucilage Extracted from Lallemantia royleana as a Suspending Agent
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The mucilage from the seeds of Lallemantia royleana family Labiatae was extracted and subjected to preformulation study for evaluation of its suitability for use as suspending agent. Furosemide suspensions were prepared using (1.5% w/v) of the extracted Lallemantia royleana mucilage, (1.5% w/v) chitosan and (0.35% w/v) xanthan gum. The mucilage was white in color and the average yield of dried mucilage obtained from L.royleana nutlets was 14 % w/w of the seeds used. It is sparingly soluble in water but swells in contact with it, giving a highly viscous solution. It is slightly acidic to neutral. It was found that the extracted natural mucilage of Lallemantia royleana exhibited a higher viscosity profil

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Publication Date
Sun Mar 27 2022
Journal Name
Journal Of The College Of Basic Education
A Cross-Cultural Study of Criticism Strategies: Iraqi and Malay ESL Learners
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        Criticism, as an evaluative criterion, is a significant speech act for English language learners to improve their speech and actions in their academic life. Yet, it is realized differently across diverse cultures. Few studies have shown that the linguistics forms of one language are different from those available in another language. Hence, this study aims to investigate the cross-cultural similarities and differences between 60 Iraqi and Malay university learners in the use of criticism strategies. The data are collected using a Discourse Completion Test (DCT) and a Focus Group Interview (FGI). The data are coded based on Nguyen’s (2005) coding scheme of criticism in terms of the realization strategies. Qualitative

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Engineering
A Laboratory Study Attempt of Flow and Energy Dissipation in Stepped Spillways
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A new laboratory study conducted on stepped spillways in order to investigate their efficiency of dissipating flow energy. All previous study on stepped spillway indicated that the flow energy dissipation decreased as increasing in discharge. Increasing in the step numbers and the spillway slope led to energy dissipation decrease. In this study, an experimental attempt to increase energy dissipation at variable discharges was performed on stepped spillway and that leads to decreasing the cost of initiating the stilling basin or may be ignoring it. Five spillways were constructed from concrete and tested to investigate and compare among them. Three were roughed by gravel with different size for each one, one of them was s

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The political violence risk insurance A possibility of its application in Iraq
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Iraqi insurance market need to develop products and to find new insurance policies to cover the damages of the violence and political commotions dangers and to meet the needs of the proposers.                                       

 The global insurance companies recently issued such policies to pay the losses wich caused by the violent political acts of vandalism suffered by the property and investments wich estimated billions of dollars.                

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Publication Date
Thu Feb 01 2018
Journal Name
Applied Mathematical Modelling
Identification of a multi-dimensional space-dependent heat source from boundary data
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