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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
Thu Jan 04 2018
Journal Name
International Journal Of Molecular Sciences
Understanding the Progression of Bone Metastases to Identify Novel Therapeutic Targets
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Publication Date
Fri Dec 01 2023
Journal Name
Methods And Objects Of Chemical Analysis
Partial Least Squares Method for the Multicomponent Analysis of Antibacterial Mixture
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This study's objective is to assess how well UV spectrophotometry can be used in conjunction with multivariate calibration based on partial least squares (PLS) regression for concurrent quantitative analysis of antibacterial mixture (Levofloxacin (LIV), Metronidazole (MET), Rifampicin (RIF) and Sulfamethoxazole (SUL)) in their artificial mixtures and pharmaceutical formulations. The experimental calibration and validation matrixes were created using 42 and 39 samples, respectively. The concentration range taken into account was 0-17 μg/mL for all components. The calibration standards' absorbance measurements were made between 210 and 350 nm, with intervals of 0.2 nm. The associated parameters were examined in order to develop the optimal c

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Solvability of Some Types for Multi-fractional Integro-Partial Differential Equation
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In this article, the solvability of some proposal types of the multi-fractional integro-partial differential system has been discussed in details by using the concept of abstract Cauchy problem and certain semigroup operators and some necessary and sufficient conditions. 

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Partial Least Squares and Principal Components Methods by Simulation
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Abstract                                                                                              

The methods of the Principal Components and Partial Least Squares can be regard very important methods  in the regression analysis, whe

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Publication Date
Wed Nov 13 2019
Journal Name
Al-kindy College Medical Journal
Early Return Of Activity Of Daily Living After Surgery Of Pfna Li Fixation In Elderly Osteoporotic Intertrochanteric
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Background:    Hip fractures are common, morbid, and costly health events that threaten independence and function of older patients . Early functional recovery is extremely important for elderly patients with femoral intertrochanteric fractures to shorten their hospital stay, omit the necessity of the further nursing and care services, and reduce associated medical expenditures . Assessment of  (ADL) is an important predictor of outcomes Of orthopedic surgery in very early postoperative period at two weeks and a month postoperatively using Japanese orthopedic score get a quick recovery of ADL & return the patient to his or her premorbid level function reducing the morbidity and mortality.

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Publication Date
Thu May 10 2018
Journal Name
Global Journal Of Health Science; Issn 1916-9736 E-issn 1916-9744
Effects of Biological and Non Biological Agents (Disease Modifying Antirheumatic Drugs) on Bone Mineral Density in a Sample of Rheumatoid Arthritis Patients
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Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D

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Publication Date
Mon Aug 04 2025
Journal Name
Iraqi Journal Of Community Medicine
Awareness and Expectation of Breast Reconstruction Surgery among Female with Breast Cancer in Baghdad Governorate 2022
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Abstract Background:Breast cancer is the most common female cancer worldwide. Although mastectomy is considered the treatment of choice for the majority of cases of breast cancer; a noticeable percentage of breast cancer survivors claim they were never advised about reconstruction. It has been proven that breast reconstruction helps breast cancer survivors to overcome the trauma of their diagnosis and improve their psychological well-being.Objectives: To assess the level of awareness and expectations regarding breast reconstruction surgery among female with breast cancer survivors in Baghdad, and to find if there is association between sociodemographic data and expectations of breast reconstruction.Methodology: This is a cross sectional stu

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Publication Date
Sun Oct 29 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nurses' Practices in Intensive Care Units Following Coronary Artery Bypass Grafting Patients in Baghdad City
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Objective: To evaluate nurses' practices toward coronary artery bypass grafting (CABG) patients in the
intensive care units (ICU) and to find out the relationship with some vanables.
Methodology: A purposive sample of (50) staff nurses was selected out of three hospitals for cardiac surgery.
The study instmment consisted of two major sections was constructed. It is based on the review of literature.
First it is concerned with demographic data for nurses; and the second section is observationaL tool (checklist) is
composed of six parts in which there mere (78) items. Reliability and validity of the observational checklist were
determined through the analysis of a pilot study.
Data were collected through the use of the

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Publication Date
Fri Jan 01 2010
Journal Name
Journal Of Baghdad College Of Dentistry
The influence of prophylactic Dexamethasone on postoperative swelling and trismus following impacted mandibular third molar surgical extraction
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Background: Pain, swelling and trismus are the main minor complications encountered after surgical extraction of impacted third molars, minimizing these postoperative complications is the center of many studies, one proposed method is the prophylactic administration of corticosteroids, the aim of this study is to evaluate the effect of prophylactic Dexamethasone administration on facial swelling and trismus after surgical extraction of impacted third molars. Materials and methods: 20 patients were included in this study, they were randomly divided into 2 groups of 10 patients each; a study group in which patients were given 8 mg. Dexamethasone 1 hour before surgical extraction of impacted third molar and 4 mg. 6 hours postoperatively, and a

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Publication Date
Tue Sep 06 2022
Journal Name
International Journal Of Professional Business Review
The Relationship Between Audit Services and Non-Audit Actuarial Services in the Auditor’s Report
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Purpose: In view of the trend toward using international financial reporting standards when generating financial statements, we looked at the interaction between audit services and non-audit services for auditors in the context of actuarial services for insurance firms. CPAs are authorized to work in banks and insurance businesses, but those with a practicing license obtained after earning a higher academic degree are not. Design/methodology/approach: A small number of auditing firms control the decisions issued by the Iraqi Accountants Association, monopolizing audit services in banks and insurance businesses. In the case of actuarial services used in reserve estimation, they are credited to an external party's account withou

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