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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 Oct 01 2009
Journal Name
Jssdds
Topical 10% lactic acid solution in the treatment of pityriasis versicolor in comparison with topical 1% clotrimazol solution (single-blind, comparative and therapeutic study)
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KE Sharquie, AA Noaimi, AM Oweid, JSSDDS, 2009 - Cited by 2

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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Cancellation in the Life Insurance Policies and its Impact on the Financial Solvency of Insurance Companies: Applied Research in the Iraqi General Insurance Company
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This research cancellations in life insurance policies and their impact on the solvency of the insurance companies (Applied Research in the Iraqi general insurance company), The study was descriptive approach in identifying and addressing variables which consists of {cancellations in life insurance} independent variable, the financial solvency of insurance companies as the dependent variable, and for the purpose of achieving the objectives of the research were formulated one hypothesis has been tested in the Iraqi insurance company, the researcher used the financial statements in the collection data needed for the study and information . The research found a number of conclusions highlighted that inflation, as well as economic variables

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The awareness degree of teacher students in Arabic language department and their supervisors at Al-aqsa University for their future role in knowledge age
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The study aimed to identify the awareness degree of teacher students in the department of Arabic language and their supervisors at Al-aqsa University for their future roles in the age of knowledge. To achieve this objective, descriptive- analytical approach was used. The instruments of this study were two questionnaires: first one consist of (20) item for teacher students, and the second consist of (27) item for educational supervisors which covered three roles: professional, technological, and humanitarian. The sample was (120) student selected randomly, and (39) supervisors of Arabic language. The result revealed that the mean of degree awareness of teacher students and their supervisors of future role are (3.857), (3.472) respectively

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Colloid Interface Science
Corrigendum to “Organic acid concentration thresholds for ageing of carbonate minerals: Implications for CO2 trapping/storage” [J. Colloid Interface Sci. 534 (2019) 88–94]
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Erratum for Organic acid concentration thresholds for ageing of carbonate minerals: Implications for CO2 trapping/storage.

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
Synthesis, Characterization and Antibacterial Activity of 1,4-di[ aminomethylene carboxyl] phenylene (H2L) and its Complexes Co(II), Cu (II), Zn(II) and Cd (II)
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of artificial intelligence in achieving Customer satisfaction and its reflection on cost accounting: An applied research in the Iraqi electronic industries company
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Based economic units to technology to add innovations that lead to contribute to customer satisfaction, under intense competition and rapid development in customer taste, the economic units tend to apply the concepts that contribute to customer satisfaction led by the introduction of artificial intelligence techniques. In the production prominent role in the contributing and responding to the rapid changes in customer tastes, and consequent impact this in achieving customer satisfaction. Search gained importance of relying on artificial intelligence techniques to achieve customer satisfaction through speed of response to changes in the tastes of customers and thus be able to increase its market share، and sales growth، and to achieve a

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Publication Date
Wed May 01 2024
Journal Name
Biology
Lysophosphatidylcholine Acetyltransferase 2 (LPCAT2) Influences the Gene Expression of the Lipopolysaccharide Receptor Complex in Infected RAW264.7 Macrophages, Depending on the E. coli Lipopolysaccharide Serotype
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Escherichia coli (E. coli) is a frequent gram-negative bacterium that causes nosocomial infections, affecting more than 100 million patients annually worldwide. Bacterial lipopolysaccharide (LPS) from E. coli binds to toll-like receptor 4 (TLR4) and its co-receptor’s cluster of differentiation protein 14 (CD14) and myeloid differentiation factor 2 (MD2), collectively known as the LPS receptor complex. LPCAT2 participates in lipid-raft assembly by phospholipid remodelling. Previous research has proven that LPCAT2 co-localises in lipid rafts with TLR4 and regulates macrophage inflammatory response. However, no published evidence exists of the influence of LPCAT2 on the gene expression of the LPS receptor complex induced by smooth or rough b

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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
Land use change in Baghdad City and assessment of the Jadriyah and Umm Al- Khanazeer Island Important Bird Area (IBA) from 1984 to 2020
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Land use change, particularly the expansion of urban areas and associated human activities at the expense of natural and semi-natural areas, is a major ecological issue in urban areas around the world. Climate change being a very strong additional driver for changing the temperature and habitat in the cities. This also applies to Baghdad, Iraq, where urbanisation and climate change exerts a major pressure on the natural habitats of the city, and thus may affect the ability of city planners to adapt to future climate change scenarios. Here we present evidence of substantial growth in urban areas, increases in temperature, and degradation of natural vegetation within Baghdad city by using Remote Sensing techniques and an assessment for the

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Publication Date
Thu Jun 11 2026
Journal Name
Journal Of Physical Education
The Effect of Breathing Exercises on Relation and Self – Talk on Developing Ambition Level According to VTS – Sport and Achievement in Long Distance Runners
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Publication Date
Tue Oct 21 2014
Journal Name
Diyala Journal For Pure Sciences
synthesis and characterization of New schiff base Ligand Derived from 4-amino anti pyrine and it's complexes with some Metal lons and theirAntibacterial studies
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synthesis and characterization of New schiff base Ligand Derived from 4-amino anti pyrine and it's complexes with some Metal lons and theirAntibacterial studies