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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
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
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
Wed Dec 03 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
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
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 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
Sun Nov 02 2014
Journal Name
Autophagy
Autophagy in osteoblasts is involved in mineralization and bone homeostasis
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Publication Date
Sat Aug 01 2015
Journal Name
Plant Disease
First Report of the Cereal Cyst Nematode <i>Heterodera filipjevi</i> on Winter Wheat in Montana
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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
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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