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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
Sat May 14 2022
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Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ < 6.0 mm. A prospective clinical study
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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Histological Evaluation of Effect of beta-Tricalcium Phosphate on Bone healing in Alloxan-Induced diabetes
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Background: Improved glucose level control with insulin injections have allowed for the diabetic population to live longer and healthier lives. Unfortunately diabetes remains a worldwide epidemic disease with multiple health implications. Specifically, its effects upon fracture healing are compromised in diabetics with as high as 87% recovery delay relative to “healthy” counterparts. Current medical treatments for bone injuries have been largely focused on replacing the lost bone with allogenic or autogenous bone grafts, beta-tricalcium phosphate (β -TCP), a ceramic alloplast, has interconnected system of micropores, has been widely used as a biologically safe osteoconductive bone substitute. The aim of this study was histol

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Publication Date
Sun Mar 01 2009
Journal Name
Diyala Journal Of Human Research
Stability of the Finite Difference Methods of Fractional Partial Differential Equations Using Fourier Series Approach
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The fractional order partial differential equations (FPDEs) are generalizations of classical partial differential equations (PDEs). In this paper we examine the stability of the explicit and implicit finite difference methods to solve the initial-boundary value problem of the hyperbolic for one-sided and two sided fractional order partial differential equations (FPDEs). The stability (and convergence) result of this problem is discussed by using the Fourier series method (Von Neumanns Method).

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Non-Linear Behavior of Strengthened Steel-Concrete Composite Beams with Partial Interaction of Shear Connectors
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In this research a theoretical study has been carried out on the behavior and strength of simply supported composite beams strengthened by steel cover plate taking into consideration partial interaction of shear connectors and nonlinear behavior of the materials and shear connectors. Following the procedure that already has been adopted by Johnson (1975), the basic differential equations of equilibrium and compatibility were reduced to single differential equation in terms of interface slip between concrete slab and steel beam. Furthermore, in order to consider the nonlinear behavior of steel, concrete and shear connectors, the basic equation was rearranged so that all terms related to materials are isol

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
The effective of partial replacement of barium by yttrium on HgBa2-xYxCa2Cu3O8+δ superconducting compound
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Publication Date
Fri Sep 17 2021
Journal Name
Review Of International Geographical Education Online
Following the Parashot Strategy in Developing Reading Understanding Skills among Female Students in the1st Middle Grade in Reading Material
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The research aimed to know the effect of the Parashot strategy in developing the reading comprehension skills of first-grade intermediate students in reading. The researchers put the following two null hypotheses: There is no statistically significant difference at the level (0.05) between the average scores of the experimental group students who study the subject Reading with the Parashot strategy in the pre and post-tests in developing reading comprehension skills as a whole. There is no statistically significant difference at the level (0.05) between the average scores of the experimental group students who study the reading material using the Parashot strategy and the average scores of the control group students who study the same subje

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Publication Date
Thu Aug 18 2022
Journal Name
Dental Hypotheses
Microleakage Evaluation of Glass Hybrid Restoration Following Usage of Papain-Based Gel and Ceramic Bur for Caries Removal: An in Vitro Study
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Letter to the Editor “Challenges of Meeting Cerebrovascular Surgery Demands in Low-and Middle-Income Countries: An Experience from Iraq”
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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
A study of Fermi hole and partial Fermi hole for Li- and C-Atoms in different states 1s 2p, 1s 3p, 1s 3d and 2s 2p
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The electron correlation effect for inter-shell have been analysed in terms of Fermi hole and partial Fermi hole for Li-atom in the excited states (1s2 3p) and (1s2 3d) using Hartree-Fock approximation (HF). Fermi hole Δf(r12) and partial Fermi hole Δg(r12 ,r1) were determined in position space. Each plot of the physical properties in this work is normalized to unity. The calculation was performed using Mathcad 14 program.

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Publication Date
Sat Sep 24 2022
Journal Name
International Journal Of Biomaterials
Histological Evaluation of the Effect of Local Application of Punica granatum Seed Oil on Bone Healing
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Background. Bone healing is a complex and dynamic process that represents a well-orchestrated series of biological events of cellular recruitment, proliferation, and differentiation. The use of medicinal plants in bone healing has attracted increasing interest because of their lower side effects. Punica granatum seed oil (PSO) contains high levels of phenolic compounds, promotes osteoblast function, and plays an important role in bone remodeling. A gelatin sponge (Spongostan) is a hemostatic agent that is extensively applied as scaffolds in engineering and as drug carriers in the medical field. This study aimed to evaluate the effectiveness of PSO for bone healing enhancement. Twenty adult male New Zealand rabbits, weighing an avera

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