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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
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Limit the auditor's personal judgment and its reflection on the quality of the audit report
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The main objective of the audit is The asset is maintained and operated efficiently and is done through to detect fraud and errors in the financial statements and to verify the accuracy and accuracy of the information contained therein and to give a neutral technical opinion on the basis of that, thus the auditor has a professional responsibility in achieving this goal, and that the effects of issuing a wrong opinion works on The loading of the beneficiaries is significant damage, And therefore the presence of any error or bias of the auditor when taking personal judgments in relation to the determination of the relative importance and the selection of audit samples and determine the adequacy and validity of evidence and implemen

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Publication Date
Fri Feb 01 2013
Journal Name
Ijbpas
THE POSSIBLE RELATIONSHIP BETWEEN SERUM TUMOR NECROSIS FACTOR ALPHA LEVEL AND THE RECOVERY OF PATIENTS WITH PULMONARY TUBERCULOSIS
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Mycobacterium tuberculosis is the cause of the major world health issue, tuberculosis (TB). The cytokine, tumor necrosis factor alpha (TNF-α) has been implicated in protection against TB in the early stages of the disease. TNF-α is an effective cytokine in the killing of intracellular M. tuberculosis. This study inducted to investigate whether there is any relationship between levels of TNF-α in sera of TB patients and their recovery, and is there any difference in the level of this cytokine in sera of female and male TB patients. This study included 29 patients with pulmonary TB (18 female and 11 male), their ages ranging from 37 to 59 years. All of them received first line TB therapy. They were consulted at Pasture Center during Septem

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Publication Date
Fri Oct 06 2023
Journal Name
Journal Of The Pakistan Medical Association
The role of Tumour Necrosis Factor Alpha (TNF-ALPHA) serum level and genetic polymorphisms with cutaneous leishmania infections
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Objective: To assess the role of tumour necrosis factor alpha level and genotyping in susceptibility to leishmaniasis.Method: The case-control study was conducted from March to July 2021 at Baqubah Teaching Hospital, Diyala, Iraq,and comprised patients of cutaneous leishmaniasis in group A and healthy controls in group B. The serum level andsingle nucleotide polymorphisms of tumour necrosis factor-alpha rs41297589 and rs1800629 were compared betweenthe groups. Data was analysed using SPSS 28.Results: Of the 150 subjects, there were 75(50%) in group A; 39(52%) males and 36(48%) females with mean age23.91±13.14 years. The remaining 75(50%) subjects were in group B; 38(50.7%) males and 37(49.3%) females withmean age 22.84±4.35 years.

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Publication Date
Sun Jan 01 2023
Journal Name
Acta Facultatis Medicae Naissensis
Malignant bone tumors in pediatric age groups in Iraq
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Introduction/Aim. Roughly six percent of all malignancies diagnosed in children are malignant bone tumors. They have a dramatic effect on psychological status of children and their families. The aim of the study was to analyze the clinico-pathological features of bone tumors in Iraqi children and to assess response to treatment, outcome, and survival. Patients and methods. Over an eleven-year period, a retrospective study was done for children with bone tumors conducted on patients data that included a battery of pre-treatment investigations including a complete blood count, serum electrolyte, hepatic, and renal profile, bone marrow aspirate and biopsy, fine-needle aspiration, and imaging studies. Results. Data of 41 children with b

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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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Publication Date
Fri Feb 17 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn: 2789-3219 )
The Association of Genetic Polymorphisms in Tumor Necrosis Factor-Alpha and Interleukins with Disease Severity or Response to Biological Therapy in Iraqi Rheumatoid Arthritis Patients: A Narrative Review
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Background: Tumor necrosis factor-alpha (TNF-α) and interleukins play important roles in the pathogenesis of rheumatoid arthritis (RA). Genetic research has been employed to find many of the missing connections between genetic risk variations and causal genetic components. Objective: The goal of this study is to look at the genetic variations of TNF-α and interleukins in Iraqi RA patients and see how they relate to disease severity or response to biological therapy. Method: Using specific keywords, the authors conducted a systematic and comprehensive search to identify relevant Iraqi studies examining the genetic variations of TNF-α and interleukins in Iraqi RA patients and how they relate to disease severity or response to biolo

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Publication Date
Mon Aug 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of orthodontic tooth movement on salivary levels of Interleukin-1beta, Tumor Necrosis Factor-alpha, and C- reactive protein
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Background: Orthodontic force is considered to stimulate cells in the periodontium to release many mediators such as cytokines which play a responsible role for periodontal and alveolar bone remodeling, bone resorption and new bone deposition. Aim of this study was carried out to estimate changes of the (interleukin-one beta, tumor necrosis factor – alpha and C-reactive protein) levels in unstimulated whole saliva during the leveling stage of orthodontic tooth movement. Materials and methods: The sample consisted of thirty adult patients (12 males and 18 females) with ages ranges (19-23) years. Each sample had Class I and Class II malocclusion dental classification and required bilateral extraction of their maxillary first premolars, und

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Publication Date
Wed Jan 01 2020
Journal Name
Medical Journal Of Babylon
Impact of chronic hepatitis B virus infection on bone mineral density
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Background: Chronic hepatitis B virus (HBV) infection is a common health problem that has a worldwide distribution. Apart from the direct effect of the virus on the liver, there are many extrahepatic manifestations among which the probable effect on bone turnover associated with low bone mineral density (BMD). Objectives: This study aimed to determine the association between treated and untreated chronic HBV infection with BMD. Methods: This is a cross-sectional study which included a total of 48 patients with chronic HBV (28 patients treated with tenofovir-disoproxil-fumarate [TDF] antiviral drug and 20 patients have not yet started treatment). Other age- and sex-matched 30 apparently healthy individuals were recruited to represent the hea

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Publication Date
Tue Jan 17 2023
Journal Name
Karbala International Journal Of Modern Science
Biofunctionalization of polyetheretherketone implant material by bone-forming peptide-2 immobilization
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Polyetheretherketone (PEEK) has favorable biomechanical properties to be used as an implant material. Unfortunately, it is hydrophobic and does not promote cellular adhesion, which could result in poor integration with bone tissue. Bio-functionalization of PEEK surface with osteogenic peptides derived from bone extracellular matrix proteins is an exciting approach to encourage bone formation around the implant. In the current study, bone-forming peptide-2 was immobilized on PEEK surface using two different methods, using dopamine and a diglycidyl ether as conjugate compounds, respectively. Peptide quantification test revealed that the two strategies resulted in the most amount of peptides were attached with 0.5 mM concentration and no furth

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Internal Fixation And Bone Grafting Of Non-Union Humeral Diaphyseal Fracture
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Background: Humeral diaphyseal fracture usually
heals with closed methods but when nonunion
develops then it needs surgical intervention in the
form of plating and bone grafting, intramedulary
nailing (open or closed simple or interlocking nails)
and external fixators (circular or one plane fixator).
In our unit we treated non union humeral
diaphyseal fracture with plating and bone grafting
shortening of fracture ends up to 4 to 5cm when
needed. Methods: This study was conducted at
Orthopaedic Department of AL-Sadar General
Hospital from January 2004 till December2005 .
We included 20 cases with atrophic non-union in
12(60%) and hypertrophic non-union in 8 (40%)
patients. All atrophic non-union w

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