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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 Jan 01 2021
Journal Name
Systematic Reviews In Pharmacy
A COMPARATIVE STUDY OF CHEMICAL COMPOUNDS AND ANTI-BACTERIAL EFFICACY OF DIFFERENT ALLIUM CEPA PLANT EXTRACTS
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Publication Date
Sun Oct 01 2023
Journal Name
Journal Of Pakistan Association Of Dermatologists
Diverse cutaneous manifestations of pyoderma gangrenosum with triple therapeutic trial in a series of 53 cases
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Publication Date
Sun Jun 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Development of a Semi-Analytical Type Curve of Transient Pressure Response in Complex Well-Reservoir Architectures
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The objective of the conventional well testing technique is to evaluate well- reservoir interaction through determining the flow capacity and well potential on a short-term basis by relying on the transient pressure response methodology. The well testing analysis is a major input to the reservoir simulation model to validate the near wellbore characteristics and update the variables that are normally function of time such as skin, permeability and productivity multipliers.

Well test analysis models are normally built on analytical approaches with fundamental physical of homogenous media with line source solution. Many developments in the last decade were made to increase the resolution of transient response derivation to meet the

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Contribution of Privatization in Tax Revenues: an applied research on a sample of filling stations
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The tax revenues achieved through projects of transition to private sector are regarded as an important source for using in achieving political, economic and social objectives. Since Iraq is heading towards free market economy, new strategies should be adopted to reform the taxation system from by a qualified taxation management office and to activate the taxation policy and to reconsider legislation in relation to the aware of the legible to the importance of disclosure of their taxable real income in order to arrive at contribution of privatization in the taxation revenues for the important role effect on economic activities. In the light of the above, the research is based upon a hypothesis which stipulates that privatization contribu

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Publication Date
Mon Jan 01 2024
Journal Name
Scripta Medica
Eruption of first permanent molar among a group of Iraqi children in relation to nutritional status
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Background/Aim: The timing of a tooth's eruption can be affected by a variety of factors. The nutritional status has an impact on the development of a child's body. The purpose of the study was to analyse the number of children aged 6 to 9 in an Iraqi Arab population who had erupted permanent first molars and to examine how nutritional status affected the timing and level of emergence. Methods: A total of 330 boys and girls, in first grade elementary school, made up the sample. First molars that had erupted were noted, along with the level of the eruption. Each child's nutritional status was evaluated by recording their height and weight and body mass index (BMI) value was compared to the 2007 WHO reference. Results: Girls had highe

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Publication Date
Tue Oct 04 2022
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Lecture Notes In Mechanical Engineering
Effect of Stator Core Materials on the Performance Characteristics of a Free Piston Linear Generator Engine
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Fri Jan 01 2021
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Journal Of Stomatology
Association of self-reported symptoms of xerostomia with vaping and cigarette smoking: a cross-sectional study
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Publication Date
Tue Nov 01 2016
Journal Name
International Journal Of Pharmaceutical Sciences Review And Research
A study on some variables affecting the preparation of ethyl cellulose based floating microspheres of lafutidine
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Lafutidine (LAF) a newly developed histamine H2-receptor antagonist with absorption window makes it a good candidate to be prepared as floating drug delivery system. The current study involves formulation and in- Vitro evaluation of lafutidine as floating microspheres. Different formulation variables that affect the physicochemical properties of the prepared microspheres besides to the drug release behavior were investigated. Fourteen formulas were prepared by emulsion (o/w) solvent evaporation method using Ethyl cellulose (EC) as the polymeric matrix and tween 80 (TW80) as an emulsifying agent. The prepared formulas were evaluated for their percentage buoyancy (%), Percentage yield (%) and Entrapment efficiency (EE %). The results obt

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Scopus
Publication Date
Fri Oct 19 2018
Journal Name
Journal Of Economics And Administrative Sciences
The impact of creative thinking in cultural intelligence Field research on a sample of medical specialists
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Basic Orientation  and search path in determining the impact of creative thinking in cultural intelligence field research on the doctors competence, as is a theme of creative thinking great importance in spite of being a old , but his role at the individual level and / or organizational a sustainable effect toward developing a fact uncommon , any sense that one of the pillars of modernity and provide a unique future, as is the competitive weapon of the organizations in an environment dubbed fundamental change and provide all that is unfamiliar, and in the center of the field of research and objective measurement of creative thinking on doctors specialists at the construction of a state of the preference and

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Publication Date
Sun Jan 01 2023
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Physical Mesomechanics Of Condensed Matter: Physical Principles Of Multiscale Structure Formation And The Mechanisms Of Nonlinear Behavior: Meso2022
Calculation of radon gas concentrations in administration rooms for a number of schools in Diyala governorate
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