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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 May 31 2022
Journal Name
Journal Of Positive School Psychology
A GENRE-BASED ANALYSIS OF POLITICAL SPEECHES IN THE UN GENERAL ASSEMBLY
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Publication Date
Wed Jan 01 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology
Color stability of different aesthetic resin composite materials: A digital image analysis
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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Global Pharma Technology
Nanocrystal Technology as a Tool for Improving Dissolution of Poorly Soluble Drugs
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Many approaches have been developed over time to counter the bioavailability limitations of poorly soluble drugs. With advances in nanotechnology in recent decades, this issue has been approached through the formulation of drugs as nanocrystals. Nanocrystals consist of pure drug(s) and a minimum of surface active agent(s) required for stabilization. They are carrier-free submicron colloidal drug delivery systems with a mean particle size typically in the range of 200 - 500 nm. By reducing particle size to nanoscale, the surface area available for dissolution is increased, and thus bioavailability is enhanced. Drug nanocrystals constitute a versatile formulation approach to enhance the pharmacokinetic and pharmacodynamic properties of poorly

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Publication Date
Sun Jan 01 2012
Journal Name
كلية التربية-الجامعة المستنصرية
Study the diffusion of Hydrogen in metals using a Runge-Kutta method
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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
A Critical Pragmatic Study of Racism as Conceptualized in the Glorious Quran
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Racism changes its meaning, shape, purpose or function according to various factors such as time, place, motives, and backgrounds; among others. It seems, however, to have deep roots back in the history of mankind. Such a concept stems from a perceived difference with the other. It is fed by the feeling of being hierarchically superior in opposition to another party that is depicted as inferior. Since ancient times, racism is disguised in different forms and manifests itself on various levels. It is a truism that this ideology can be best presented via language.

Due to its negative implication, racism lends itself to a critical kind of research.  As such, this paper is a critical pragmatic investigation for this phenomenon a

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Differences of Style between English and Arabic Political Discourse: A Contrastive Study
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Traditionally, style is defined as the expressive, emotive or aesthetic emphasis added linguistically to the discourse with its meaning is the same. In the current study, however, style is defined as the linguistic choice that the language users can make for specific purposes.

    This study, thus, aims at analyzing political Arabic and English speeches to find out whether there are differences of style between English and Arabic and whether the choices the language users make  can show any traits of their psychological status.

    To fulfill the above aims, the study hypothesizes that English and Arabic  speeches can be analyzed stylistically and that there are stylistic difference

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Publication Date
Wed Mar 04 2015
Journal Name
Environmental Earth Sciences
Isotopic study of water resources in a semi-arid region, western Iraq
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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of the Satirical Language in Al-Hajjar's Caricatures
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The present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me

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Publication Date
Mon Sep 30 2024
Journal Name
Nasaq
A Semiotic Analysis Of Visual-Textual Elements In TobaccoFree Initiative 2021 Advertisements
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The provided research paper offers a thorough analysis of the semiotic analysis present in tobacco-free initiative advertisements from the year 2021. The study delves into the intricate process of decoding the diverse signs, symbols, and visual components integrated into these anti-smoking campaigns. The core aim of this investigation is to comprehend and explore the semiotic tactics that underlie these advertisements, with a particular emphasis on visual communication as a pivotal tool in shaping the public's attitudes and behaviors towards tobacco usage. The research introduces a significant theoretical framework, the "Taxonomy of Image-Text Relations and Functions" theory, as proposed by Emily E. Marsh and Marilyn Dom

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Publication Date
Wed Mar 05 2025
Journal Name
Lecture Notes In Networks And Systems
Leveraging AI for Disaster Management: A Comprehensive Review of Applications and Challenges
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