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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
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Audit Committees and Audit Quality on Timeliness of issuing annual Financial Report
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The aim of this study is to get practical evidence from the Egyptian business environment The Impact of Audit Committees Effectiveness and External Audit Quality on Timeliness of annual Financial Report. Design and methodology: The study based on the content analysis technique to examine the annual reports of a sample of (30) companies listed on the Egyptian Stock Exchange (EGX100) during the period (2016-2019) with a total of (120) respondents. To test the research hypotheses, the results of the study indicate that there is a negative significant impact of audit committees on timeliness of annual financial report. Moreover, while there is a negative impact on the quality of the external audit on the timing of issuing the annual

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Publication Date
Fri Aug 01 2025
Journal Name
Journal Of Water Process Engineering
Fabrication of AgBr/Br-doped g-C3N4 hybrids for efficient piezo-photocatalytic degradation of organic pollutants in split-plate airlift reactor
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The use of piezocatalysis with photocatalysis in the degradation of organic pollutants has become an attractive research field due to the enhanced synergistic effect of the two processes. Herein, binary composites of AgBr decorated onto Br-doped g-C3N4 in different weight percentages (AgBr content was varied from 10 wt% to 40 wt%) have been built as heterojunction piezo-photo catalysts with a highly efficient performance. The 20 wt%AgBr/Br-g-C3N4 catalysts showed synergistically improved piezo-photo catalytic decomposition toward Methylene blue (MB) under visible-light and sonication exposure in a simple constructed split-plate airlift contactor, completing 99.7 % degradation of MB within 60 min. The heterogeneous junction established among

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Publication Date
Sat Dec 30 2023
Journal Name
Basrah Journal Of Surgery
Can Hyaluronic acid gel enhance wound healing faster than Advanced Platelets Rich Fibrin following surgical removal of impacted mandibular third molars? A Randomized Controlled Trial
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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
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
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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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
Sun Mar 01 2026
Journal Name
Continence Reports
Urodynamic changes following augmentation cystoplasty in pediatric patients with neurogenic lower urinary tract dysfunction
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Abstract Background: Augmentation cystoplasty is one of the surgical procedure for treatment of spastic neurogenic bladder that has a significant improvement in the cystometric parameters. Aim of study: The aim of this study is to describe cystometric findings pre and post augmentation cystoplasty in patients with spastic neurogenic bladder. Patients and methods: A prospective study including patients aged 6-18years with neurogenic bladder operated on for augmentation cystoplasty surgery with ilium segments due to a neurogenic bladder from the years 2020–2024. A urodynamic study was conducted before and 3 months after the surgical procedure. Non-probabilistic sample of consecutive cases. Descriptive statistics were presented using fre

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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
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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