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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
Sat Mar 01 2025
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Intradural extra-medullary spinal cord tumor after dorso-lumbar spine fixation following 12th dorsal vertebra burst fracture: A case report with literature review
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Publication Date
Wed Apr 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Augmentation of the localized bony defects with synthetic bone substitute in simultaneous dental implant surgery(Clinical study)
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Background: Simultaneous and staged guided bone regeneration (GBR) is one of the several surgical techniques that have been developed in the past two decades to regenerate bone and thus to allow implant placement in compromised sites (fenestration and dehiscence). It is a surgical procedure that consists of the placement of a cell-occlusive physical barrier between the connective tissue and the alveolar bone defect. The treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabi

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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Oral And Maxillofacial Surgery, Medicine, And Pathology
Cheek onchocercoma: A case report
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Onchocerciasis is an infection with cutaneous, ocular and systemic manifestations caused by the filarial nematode Onchocerca volvulus, which is transmitted by the bite of various species of the anthropophilic blood-sucking Simulium vectors (black flies). Onchocerciasis is endemic to the savannahs and rainforests of subequatorial Africa and in some countries of the Arabian Peninsula, notably Yemen and Oman, and in Central America, and the Amazon basin of South America. Onchocercomas, which can be defined as subcutaneous fibrous nodules containing adult worms, are among the variable clinical manifestations of this infestation; they are either superficial or deep and usually located over bony prominences. In this paper we report a case of an o

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of Oral And Dental Research
Ameloblastic Carcinoma of Mandible : A Case Report
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Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. there is no standard treatment protocol for this lesion but radical surgical excision with or without radiotherapy is reported in the majority of cases. In this paper we present a case of a 60 year old female diagnosed with ameloblastic carcinoma of the mandible that was treated by radical resection of the mandible with selective neck dissection and postoperative radiotherapy.

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Publication Date
Mon Dec 25 2017
Journal Name
Biomedical And Pharmacology Journal
Evaluation of Crestal Bone Loss and Alkaline Phosphatase Level in Saliva According To Different Flap Designs in Single-Tooth Dental Implant Surgery (A Clinical Comparative Study)
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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Craniofacial Surgery
Evaluation of the Trephine Method in Harvesting Bone Graft From the Anterior Iliac Crest for Oral and Maxillofacial Reconstructive Surgery
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Publication Date
Sun Sep 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Determination of Corrosion Parameters for a Cathodic Reaction Complicated by IR Drop Effect in a Flow System
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Publication Date
Thu Feb 17 2022
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Journal Of Discrete Mathematical Sciences And Cryptography
Periodical split for the groups
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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Joubert Syndrome: Imaging Findings and Report of a Case
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Background: Joubert syndrome (JS) is a very rare autosomal recessive disorder characterized by agenesis of cerebellar vermis, abnormal eye movements, respiratory irregularities, and delayed generalized motor development. Retinal dystrophy and cystic kidneys may also be associated with this clinical syndrome. The importance of recognizing JS is related to the outcome and its potential complications. This syndrome is difficult to diagnose clinically because of its variable phenotype. Its neuroimaging hallmarks include the characteristic molar tooth sign and bat wing-shaped fourth ventricle

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Publication Date
Thu Jun 06 2019
Journal Name
Indian Journal Of Public Health, Research And Development
Clinical Manifestation of Singleton Pregnancy Complicated by Diabetes Mellitus
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