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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 Mar 10 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Functional Outcome Following Synthetic Vertebral Body Implantation in the Management of Spinal Disorders
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OBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurologic

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Publication Date
Thu Feb 01 2018
Journal Name
Iosr Journal Of Dental And Medical Sciences (iosr-jdms)
Inhibitory Effects of Nickel Chloride on Bone Composition
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Abstract: To study the effect of nickel chloride on bone composition of mice, a number of biophysical and biochemical parameters have been made use. The animals were divided into control and experimental and further subdivided into three groups I, II and III according to the dose of nickel chloride (NiCl2) administered to them i.e. 5.8, 12.8 and 28.2 mg/kg body weight, respectively. Femur bones were obtained by sacrificing the animals three weeks after weaning them once a week. The percentage loss between the wet weight and dry weight of femur in control animals was found to be 32.5+1.5 .In the three experimental groups I,II and III, the percentage loss was 30.4+1.4, 35.3+2.3 and 38.9+2.2 respectively. The percentage loss between the wet we

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Publication Date
Mon Aug 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Extrafollicular Cystic Adenomatoid Odontogenic Tumor of the Mandible Associated with Clear Cell Calcifying Epithelial Odontogenic Tumor: A Rare Case Report
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Background: The adenomatoid odontogenic tumor is a relatively rare benign epithelial odontogenic tumor. It contains both epithelial and mesenchymal components. Few cases presented as an extrafollicular lesion or involve the mandible or associated with other odontogenic lesions. This paper represents a rare case of an extrafollicular AOT. Case presentation: A 24-year-old female had a painless swelling on the right side of the lower jaw since one-month duration. Intraorally there was a well defined fluctuant-blue swelling in the right alveolar premolar region measuring 1×2 cm obliterating the right lower buccal vestibule. Grade II mobility in the vital 44 and 45 teeth were observed. Panoramic radiographs showed a well-defined pear shaped

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Publication Date
Mon Jan 01 2024
Journal Name
Revista Española De Cirugía Oral Y Maxilofacial
The correlation of alveolar trabecular bone microstructure with bone density measured by cone-beam computed tomography (CBCT) and implant stability
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Publication Date
Thu Nov 01 2012
Journal Name
Journal Of Computer Science
VOICE ACTIVATION VISUALIZATION FOR ECHOCARDIOGRAPH AND 3D ANGIOGRAPHIC IMAGES IN SURGERY
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In some cases, surgeons need to navigate through the computer system for reconfirmation patients’ details and unfortunately surgeons unable to manage both computer system and operation at the same time. In this paper we propose a solution for this problem especially designed for heart surgeon, by introducing voice activation system with 3D visualization of Angiographic images, 2D visualization of Echocardiography processed video and selected patient’s details. In this study, the processing, approximation of the 3D angiography and the visualization of the 2D echocardiography video with voice recognition control are the most challenging work. The work involve with predicting 3D coronary three from 2D angiography image and also image enhan

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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)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro

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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)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-

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Publication Date
Wed Apr 01 2020
Journal Name
Brazilian Dental Journal
In Vitro Homeostasis of Rat Oral Epithelial Cell Cultures Following Withdrawal of Periodontal Pathogens
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Abstract Inflammation of periodontal tissues is the consequence of interaction between periodontal pathogens and immune system. This is associated with increased expression of inflammatory cytokines, which may exert destructive effect to the periodontal tissues when released over long period. The aim of this study was to chronologically track the homeostasis of oral keratinocytes following removal of periodontal pathogens. This was done by investigating expression of selected inflammatory markers and integrity of epithelial monolayers in vitro. Rat oral keratinocytes were stimulated with heat-killed Fusobacterium nucleatum and Porphyromonas gingivalis over 7-days then bacteria were washed away and epithelial cells re-cultured for 3-

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Publication Date
Tue Nov 29 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A proposed form for the Combined Assurance report and its impact In achieving sustainable development in the Iraqi economic units
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Despite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance  providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es

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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Lower Ureteral Obstruction and Leakage in the First Month Following Renal Transplantation
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Background: Transplantation has revolutionized
treatment of end- stage renal disease (ESRD) by proving
more cost effective than hemodialysis, with a lower
morbidity and improved quality of life.
Objective: To evaluate the development of these
complications in the first month postoperatively and
correlate their development to the type of donation
whether related or unrelated.
Methods: Fifty (50) patients aged (15-62) years, with a
mean age (34.46 ± 12.4 SD) years with (ESRD), who
underwent renal transplantation from September 2000 to
October 2002, were followed-up for one month
postoperatively clinically and by assessment of renal
function tests, sonographic and Doppler examinations.
Ureteral obs

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