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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
Mon Oct 06 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of the Efficacy of Sinus Balloon Technique on Transcrestal Maxillary Sinus Floor Elevation Surgery
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Background: A minimally invasive antral membrane balloon elevation (MIAMBE) has been introduced to overcome the invasiveness of modified Caldwell-Luc (lateral approach) and the drawbacks of the osteotome (summers' technique) in maxillary sinus floor elevation surgery. Materials and methods: A total of 13 adult Iraqi patients aged 28-55 years, 4 males and 9 females underwent sinus floor elevation surgery via crestal approach by using sinus balloon technique. A panoramic radiograph and (Cone beam computed tomography (CBCT)/or medical CT scan) were obtained before and after surgery. Postoperative gained bone was assessed and the patient reactions including pain, nasal bleeding, and ecchymosis were recorded. The whole follow up period was 1yea

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Publication Date
Wed Mar 01 2023
Journal Name
Journal Of Engineering
Producing Load Bearing Block Using LECA as Partial Replacement of Coarse Aggregate
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The ability to produce load-bearing masonry units adopting ACI 211.1 mix design using (1:3.2:2.5) as (cement: fine aggregate: coarse aggregate) with slump range (25-50mm) which can conform (dimension, absorption, and compressive strength) within IQS 1077/1987 requirements type A was our main goal of the study. The ability to use low cement content (300 kg/m3) to handle our market price products since the most consumption in wall construction for low-cost buildings was encouraging. The use of (10 and 20%) of LECA as partial volume replacement of coarse aggregate to reduce the huge weight of masonry blocks can also be recommended. The types of production of the load-bearing masonry units were A and B for (

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Some Semi-parametric Methods in Partial Linear Single-Index Model
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The research dealt with a comparative study between some semi-parametric estimation methods to the Partial linear Single Index Model using simulation. There are two approaches to model estimation two-stage procedure and MADE to estimate this model. Simulations were used to study the finite sample performance of estimating methods based on different Single Index models, error variances, and different sample sizes , and the mean average squared errors were used as a comparison criterion between the methods were used. The results showed a preference for the two-stage procedure depending on all the cases that were used

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Structural Behavior of Reinforced Concrete Hollow Beams under Partial Uniformly Distributed Load
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A Longitudinal opening is used to construct hollow core beam is a cast in site or precast or pre stressed concrete member with continuous voids provided to reduce weight, cost and, as a side benefit, to use for concealed electrical or mechanical runs. Primarily is used as floor beams or roof deck systems. This study investigate the behavior of six beams (solid or with opening) of dimension (length 1000 x height 180 x width120mm) simply support under partial uniformly distributed load, four of these beam contain long opening of varied section (40x40mm) or (80x40mm). The effect of vertical steel reinforcing, opening size and orientations are investigated to evaluate the response of beams. The experimental behavior based on load-deflection

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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
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
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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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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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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