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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 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
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
Fri Jun 20 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 Sep 05 2010
Journal Name
Baghdad Science Journal
Effect of Partial Coherence illuminated bar on evaluation technique of diffraction image
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In this work, we are obviously interested in a general solution for the calculation of the image of a single bar in partially coherent illumination. The solution is based on the theory of Hopkins for the formation of images in optical instruments in which it was shown that for all practical cases, the illumination of the object may be considered as due to a self – luminous source placed at the exit pupil of the condenser , and the diffraction integral describing the intensity distribution in the image of a single bar – as an object with half – width (U0 = 8 ) and circular aperture geometry is viewed , which by suitable choice of the coherence parameters (S=0.25,1.0.4.0) can be fitted to the observed distribution in various types of mi

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Crossref
Publication Date
Fri May 25 2018
Journal Name
Journal Of Physics: Conference Series
Partial purification of Leucine aminopeptidase (LAP) in Acromegalic Sample of Iraqi Patients
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Publication Date
Thu Dec 05 2024
Journal Name
Shifaa
Evaluating alveolar bone thickness in upper and lower incisors from orthodontic perspective. A Cone beam computed tomography-based retrospective study
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Purpose: This study aimed to assess the thickness of alveolar bone of maxillary and mandibular incisors from orthodontics perspective. Materials and Method: A total of 73 Cone beam computed tomography for Iraqi patients (47 females and 26 males) were included in this study. The selected images were captured and imported to AutoCAD database software to perform the measurement. To measure alveolar bone thickness, a reference line was drawn through the long axis of each incisor, from the incisal edge to the root apex. Then, labial and lingual/palatal perpendicular lines were drawn to the reference line at 3, 6, and 9mm apically from the cemento-enamel junction (CEJ). Results: The buccal bone is generally thinner than the lingual/palata

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Crossref
Publication Date
Sat Sep 01 2018
Journal Name
J Of Baghdad College Of Dentistry
Serum Tumor Necrosis Factor Alpha and High Sensitive C-Reactiveprotein as Biomarkersin Periodontitis in Iraqi Patients with Osteoarthritis
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Publication Date
Fri Dec 23 2022
Journal Name
F1000research
Association between polymorphisms within the gene coding for tumor necrosis factor (TNF)-alpha with outcomes of treatment in a sample of Iraqi patients with ankylosing spondylitis taking etanercept: an observational study
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Background:Ankylosing spondylitis (AS) is a progressive, chronic inflammatory illness with an unclear etiology that explicitly targets the vertebral column, peripheral joints, and extraarticular tissues. The purpose of this research was to investigate if the existence of single nucleotide polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at positions -1031T/C (rs199964), -857C/T (rs1799724) and -806C/T (rs4248158) in a sample of Iraqi AS patients could influence the patients' outcomes with etanercept.

Methods:Sixty patients with established AS receiving only etanercept were selected to enroll in this study, with a mean age of 40.75±8.6

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Crossref (2)
Crossref
Publication Date
Thu Feb 01 2018
Journal Name
Research Journal Of Pharmaceutical,biological And Chemical Sciense
correlation of serum tumor necrosis factor alpha and high sensitive c-reactive protein with clinical periodontal parameters in osteoarthritis patients
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