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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 Nov 01 2024
Journal Name
Heliyon
Strength and Deformation of Encased Concrete Columns by I- Section Steel and I- Section GFRP Subjected to Different Load Conditions
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Publication Date
Wed Jan 01 2014
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Reaction 32 70 70 33 Ge p n As (, ) γ Using a2-ratio Method.
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The δ-mixing of γ-transitions in 70As populated in the 32 70 70 33 Ge p n As (, ) γ reaction is calculated in the present work by using the a2-ratio methods. In one work we applied this method for two cases, the first one is for pure transition and the sacend one is for non pure transition, We take into account the experimental a2-coefficient for previous works and δ -values for one transition only.The results obtained are, in general, in a good agreement within associated errors, with those reported previously , the discrepancies that occur are due to inaccuracies existing in the experimental data of the previous works.

Publication Date
Sat Aug 05 2017
Journal Name
Oriental Journal Of Chemistry
Adsorption of 4-Chlorophenol from Aqueous Solution onto Iraqi Bauxite and Surfactant–modified Iraqi Bauxite: Equilibrium, Kinetic, and Thermodynamic Studies
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Natural Bauxite (BXT) mineral clay was modified with a cationic surfactant (hexadecy ltrimethy lammonium bromide (BXT-HDTMA)) and characterized with different techniques: FTIR spectroscopy, X-ray powder diffraction (XRD) and scanning electron microscopy (SEM). The modified and natural bauxite (BXT) were used as adsorbents for the adsorption of 4- Chlorophenol (4-CP) from aqueous solutions. The adsorption study was carried out at different conditions and parameters: contact time, pH value, adsorbent dosage and ionic strength. The adsorption kinetic (described by a pseudo-first order and a pseudo-second order), equilibrium experimental data (analyzed by Langmuir, Freundlich and Temkin isotherm models) and thermodynamic parameters (change in s

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Publication Date
Mon Jan 01 2024
Journal Name
Clinical Laboratory
Histopathological Tracing of HPV Genotypes 6 and 11 in Pediatric Patients in Medical City with Chronic Palatine and Pharyngeal Tonsillitis
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Publication Date
Sun Jan 22 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of international Accounting Standard No (21) in reducing tax obstacles : applied research in the General Authority for Taxes .
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               The research aimed to shed light on the impact of international Accounting Standard No (21) on tax obstacles represented by (tax evasion, double taxation) The financial statements of a group of banks operating in the private sector were relied upon to know the impact of the standard on tax obstacles, as well as knowing the amount of amounts, The researcher relied on the method of financial analysis of that data, which was obtained from the website of the Securities Commission, and conducted personal interviews with a number of university professors, chartered accountants, financial experts, banks, and the General Authority for Taxes to benefit from their

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Preparation, Characterization & Biological activity for Some Iron(II) Complexes Containing Mixed Ligands (Benzilazine & Semicarbazone) & Study of Laser Effect on Them
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The research included preparation of new iron(II) complexes with mixed ligands including benzilazine(BA) and semicarbazone ligands {benzilsemicarbazone- BSCH or benzilbis(semicarba-zone)- BBSCH2 or salicylaldehydesemicarbazone- SSCH2 or benzoinsemicarbazone- B'SCH2}.by classical and microwave methods. The resulted complexes have been characterized using chemical and physical methods. The study suggested that the above ligands form ionic complexes having formulae [Fe(SCHi)(BA)(Cl)m](Cl)2-m {where SCH, BSCH, BBSCH2, SSCH¬2 or B'SCH2 ligands; m=1 or 2}. Hexacoordinated mononuclear complexes have been investigated by this study and having octahedral geometries. The effect of laser ray type visible region have been studied on solid ligands and

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Publication Date
Tue Nov 01 2022
Journal Name
Environmental Technology & Innovation
Photo-Fenton-like degradation of direct blue 15 using fixed bed reactor containing bimetallic nanoparticles: Effects and Box–Behnken optimization
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This study involved the treatment of textile wastewater contaminated with direct blue 15 dye (DB15) using a heterogeneous photo-Fenton-like process. Bimetallic iron/copper nanoparticles loaded on bentonite clay were used as heterogeneous catalysts and prepared via liquid-phase reduction method using eucalyptus leaves extract (E-Fe/Cu@BNPs). Characterization methods were applied to resultant particles (NPs), including SEM, BET, and FTIR techniques. The prepared NPs were found with porous and spherical shapes with a specific surface area of particles was 28.589 m2/g. The effect of main parameters on the photo-Fenton-like degradation of DB15 was investigated through batch and continuous fixed-bed systems. In batch mode, pH, H2O2 dosage, DB15 c

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Publication Date
Thu Oct 25 2018
Journal Name
Al-nahrain Journal Of Science
Synthesis of some New 3-Substituted Heterocyclic Compounds Containing Bridgehead Nitrogen from 2-Amino Pyridine with Study Their Biological Activity
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Publication Date
Fri Jan 01 2010
Journal Name
Diala, Journal
Synthesis and characterization of ( L- proline ) amino acid with (Mn+2 , Fe+2 , Co+2 , Zn+2 and Cd+2 )
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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
Measurement of the Radon Concentration and Annual Effective Dose in Malva sylvestris (Khabbaz) Plant Used in Traditional Medicine and Food
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In this study, the radon gas concentration as well as the annual effective dose in leaves of the Malvasylvestris (Khabbaz) plant used in the traditional treatment and as food in Iraq, for this, it is necessary to evaluate the concentrations radon gas, which were measured using solid state nuclear track detectors (SSNTDs) CR-39 technique.  The  concentration and annual effective dose in samples were collected from Baghdad city ranged from minimum to maximum value 15.815 , 0.498 , 54.445 , 1.717  respectively, while the values of  concentration and annual effective dose in a sample collected from Karbala are 15.297 ,0.482 . These values of  concentration and annual effective dose less were compared with th

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