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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 01 2018
Journal Name
Journal Of Engineering
Performance enhancement of Echo Cancellation Using a Combination of Partial Update ( PU) Methods and New Variable Length LMS (NVLLMS) Algorithm
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In this paper, several combination algorithms between Partial Update LMS (PU LMS) methods and previously proposed algorithm (New Variable Length LMS (NVLLMS)) have been developed. Then, the new sets of proposed algorithms were applied to an Acoustic Echo Cancellation system (AEC) in order to decrease the filter coefficients, decrease the convergence time, and enhance its performance in terms of Mean Square Error (MSE) and Echo Return Loss Enhancement (ERLE). These proposed algorithms will use the Echo Return Loss Enhancement (ERLE) to control the operation of filter's coefficient length variation. In addition, the time-varying step size is used.The total number of coefficients required was reduced by about 18% , 10% , 6%

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Publication Date
Mon May 06 2024
Journal Name
Journal Of Pakistan Association Of Dermatologists
Assessment of tumor necrosis factor alpha and interleukinـ10 in obese psoriatic patients before and after using apremilast
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Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders.   Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients.   Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and

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Publication Date
Tue Dec 31 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Role of Microelements of Lumbar Disc Degeneration in Patients Undergoing Lumbar Spine Surgery
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Background: Lumbar disc degeneration (LDD) is a common musculoskeletal disorder that frequently causes low back pain (LBP). In addition to the discomfort of lower back pain, it can accompany pain in one or both legs. The lumbar spine and sacrum, consisting of five vertebrae and one bone, determine the spine's balance. Microelements are essential in bone metabolism and are associated with the prevention of osteoporosis and the alleviation of musculoskeletal pain. Objectives: To examine the correlation between lumbar spinal surgery and the concentrations of microelements, namely zinc and copper. Methods: A case-control study was conducted in Ghazi Al-Hariri Hospital in Baghdad, Iraq, during the period from October 2023 to January 2024

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Publication Date
Fri Sep 09 2022
Journal Name
Surgical Neurology International
WhatsApp as a remote patient-monitoring tool in low- and middle-income countries: Experience from the cerebrovascular surgery service in Iraq
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Publication Date
Sat Oct 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Management of Independent Middle Mesial Canal in Mandibular First Molar Using Cone Beam Computed Tomography Imaging as an Adjunct – A Case Report
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The primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.

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Publication Date
Tue May 30 2023
Journal Name
Gsc Biological And Pharmaceutical Sciences
Anatomical study of the 3rd metacarpal bone of some mammals
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The current study included the anatomical structure of the metatarsal bone in sheep in terms of the traditional structural description of the bone, as it was found that the metatarsal bone in the fore and hind limbs of adult sheep had no visible differences between it and animals, especially ruminants. The metacarpal \tarsal bone No. 3 was cylindrical in shape, with the presence of the metacarpal \tarsal bones 2 and 4 declines, articulated from the proximal end with the metacarpal and metatarsal bones whereas from the distal part with the fetlock joint and the first phalanx bone. The aim of the study is to determine whether the environment and its changes in Iraq have affected the animals and their bones in terms of length, thicknes

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Publication Date
Sat Oct 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The role of topical application of bone morphogenetic protein 7 (BMP7) on bone healing on rabbits (Immunohistochemical study on TGF-β 3 & IGF-1R)
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Background: Bone is essentially a highly vascular, living, constantly changing mineralized connective tissue. It is remarkable for its hardness, resilience and regenerative capacity, as well as its characteristic growth mechanisms. This study aimed to: 1. To evaluate the effect of bone morphogenetic protein7 (BMP7) on bone healing in artificially created intrabony defect in rabbits upper diastema, histologically. 2. To study the immunohistochemical expression of TGF-β3 and IGF-1R as bone formation markers in experimental and control groups during bone healing. Material and method: Forty male rabbits, was used in this study, 8 rabbits for each healing interval (3 days, 1,2 ,4 and 6 weeks). In each rabbit two bone holes were created on th

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Publication Date
Mon Sep 19 2022
Journal Name
Gynecology And Obstetrics Case Report
A Case Report of Intrauterine Fetal Death with Three Loops of Umbilical Cord around Neck, Keratin Hair Treatment during Pregnancy Could be the Cause
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Publication Date
Sat Apr 29 2023
Journal Name
International Journal Of Biomaterials
The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial
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One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group

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Publication Date
Sat Aug 01 2015
Journal Name
International Journal Of Advanced Research In Computer Science And Software Engineering
Partial Encryption for Colored Images Based on Face Detection
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