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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
Wed May 31 2017
Journal Name
Journal Of Engineering
A Study of Parameters Affecting the Solvent Extraction-Flocculation Process of Used Lubricating Oil
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The aim of this study was to investigate the effect of operating variables on, the percentage of removed sludge (PSR) obtained during re-refining of 15W-40 Al-Durra spent lubricant by solvent extraction-flocculation treatment method. Binary solvents were used such as, Heavy Naphtha (H.N.): MEK (N:MEK), H.N. : n-Butanol (N:n-But), and H.N. : Iso-Butanol (N:Iso:But). The studied variables were mixing speed (300-900, rpm), mixing time (15-60, min), and operating  temperature (2540, oC). This study showed that the studied operating variables have effects where, increasing the mixing time up to 45 min for H.N.: MEK, H.N.: n-Butanol  and 30 min for H.N.: Iso-Butanol increased the PSR, after that percentage was decreased; increasing t

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Publication Date
Thu Dec 31 2020
Journal Name
Pollution Research Journal
ANALYSIS OF THE HYDRAULIC CHARACTERISTICS OF AL MAHAWIL STREAM USING HECRAS: A FIELD STUDY
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A water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte

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Publication Date
Thu Dec 15 2022
Journal Name
Al-adab Journal
Metaphors and comparisons as a means of rethinking the phenomena of the surrounding world
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The article characterizes metaphors and comparisons as a means of rethinking the phenomena of the surrounding world; two directions are named within which metaphors and comparisons are studied: 1) the linguo-classification direction combines several classifications of metaphors and comparisons, which are basically focused on comparing two denotations through the meanings of word forms that are part of the trope; 2) the theoretical and conceptual direction is associated with the concept of conceptual displacement and is the basis of the theoretical and methodological study of metaphor and comparison, i.e. the modern theory of metaphor is being formed; The main attention is focused on the comparative concept of Aristotle, which postul

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Publication Date
Sun Feb 18 2024
Journal Name
Fitness, Performance And Health Journal
A Comparative Study of Some Types of Muscular Strength Among Middle-Distance Runner Athletes
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The research aims to conduct a comparative study between the events (800) m and (1500) m track in the types of muscular strength and to identify the differences between them among Iraqi sports club players. The sample represented the players participating in the Iraqi Athletics Championship for the period between (02/11/2023) and (04 /11/2023), and their number was (16) players (8) for each event, as the selection was made intentionally.  The researchers used the descriptive approach to achieve the goal of the research and used the statistical package (SPSS) to process the data statistically. According to the results collected, it was found that there was superiority among the intermediate track players (800) m in explosive power and the s

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
HISTORY AND MODERNITY OF POETRY AS : A Reference Of The Modern Poem In Iraq
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One of the most important intellectual issues, which receive attention is the issue of modernity, it has occupied the scholars of all time. However, modern poetry used to have special care in Iraq and in the Arab countries .. it is not strange that the concept of modernity is linked to history .. or having history as the most important dimension of its dimensions .. because Arab poetry is historical and it is moving into an area of ​​the past that is still active in terms of language and literary image .. When some poets found that changing and modernizing poetry became a necessity of evolution, and one of the fundamentals of modernization, the cultural impact did not respond to the desire of poets, and their impulse in modern poetry

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Impact of different sources of noise exposure on hearing impairment: A cross- sectional study
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Background: Mental health is integrated into PHC as a strategy of WHO to fill the gap in mental health treatment. Part of this strategy needs a level of task shifting so that mental health care is provided by different level of PHC workers and not only specialists such as psychiatrists and psychologists.

Objectives: To assess the knowledge and attitudes of family doctors regarding the provision of psychological health in PHCC and if there is an association between the certificates of these family doctors and their Knowledge and attitudes to psychological health.

Subjects and Methods:  A cross-sectional descriptive study with analytic elements was conducted in 8 famil

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Publication Date
Fri Jul 28 2023
Journal Name
Journal Of Advanced Pharmaceutical Technology & Research
Development of a spectrophotometric analytical approach for the measurement of cefdinir in various pharmaceuticals
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Publication Date
Wed Jun 26 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synthesis of Acetylenic Derivatives of a Substituted 1, 3, 4-Thiadiazole as Antibacterial Agents
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Scopus Crossref
Publication Date
Sun Jan 01 2023
Journal Name
مجلة ميسان للدراسات الأكاديمية
Natural Fibers Reinforcement Of Denture Base Materials: Natural Wool Reinforcement:, A Review Of Literature
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Crossref
Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Evaluation of Vitamin D level in thalassemia patients: The experience of a single center
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