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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
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Evaluation of Serum Osteocalcin and Osteopontin Levels as Bone Biochemical Markers in Postmenopausal Women.
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Background: Studies discussing the correlation between biochemical markers of bone turnover and the diagnosis of osteoporosis in postmenopausal Iraqi women are rare. This study is devoted to find out the significance of serum osteocalcin (OC) and osteopontin (OPN) levels with the incidence of osteoporosis and its major complication (fracture).Objectives: to investigate the significance of bone turnover biochemical markers; serum osteocalcin and serum osteopontin in evaluating osteoporosis for postmenopausal Iraqi women with and without history of vertebral fracture, as well as to explore the relationship of these markers with bone mineral density (BMD).Methods: Fifty seven postmenopausal women whose ages are fifty years old and over, cat

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Scaphoid Fracture Non Union Treated by Bone Graft and Plaster of Paris Cast Splint.
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Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).
Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.
Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end

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Publication Date
Sun Jun 03 2012
Journal Name
Al-kindy College Medical Journal
Scaphoid Fracture Non Union Treated by Bone Graft and Plaster of Paris Cast Splint.
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Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ). Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months. Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end of 3rd mo

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Publication Date
Mon Apr 17 2023
Journal Name
International Journal Of Veterinary Science And Medicine
Donor variability of ovine bone marrow derived mesenchymal stem cell - implications for cell therapy
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Publication Date
Sun Sep 02 2012
Journal Name
Baghdad Science Journal
Effect of Replacing Partial of Wheat Flour by Lentil Powder on Quality Properties of Laboratory Bread
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This investigation was carried out to examine the effect of replacing partial of flour by dried Lentils (Lens culinaris) to white flour in different percentages on the chemical, sensory and storage properties of the Laboratory bread. The results revealed that replacing 0% than wheat flour by lentil powder (1) control was high significan than the replacing 25 and 35% than wheat flour by lentil powder ( 4 and 5) in flavor and chewiness . The results of sensory evaluation showed that replacing 4 were high significan different than that of replacing 1 in external layer colour. Other replacing percentages, however, did not show significant differences of in comparison with control . In regards with chemical analysis of Iron and copper, i

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Publication Date
Wed Dec 02 2020
Journal Name
Iraqi Journal Of Agricultural Sciences
EVALUTION OF ANTIMICROBIAL ACTIVITY OF PARTIAL PURIFIED BACTERIOCIN FROM LOCAL ISOLATE OF BACILLUS LICHENIFORIMS HJ2020 MT192715.1
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This study was aimed to produce bacteriocin from Bacillus. licheniformis isolated from local soil of corn and sunflower fields and using as antimicrobial agent . Fourteen of local isolates of Bacillus sp. were obtained and ability of these isolates for growth on Brain heart infusion agar (BHI) at 550C were tested. Isolate C4 was revealed high growth density in comparison with other isolates. Isolate C4 was identified as Bacillus licheniformis according to morphological, cultural and biochemical tests, Moreover genetic analysis for 16S rRNA gene and given accession number MT192715.1 in GenBank of NCBI . Production of bacteriocin from this isolate was carried out in Luria Broth (LB) and partially purified by precipitation with 30-70 % saturat

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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 Dec 02 2012
Journal Name
Baghdad Science Journal
Estimation Activity And Partial Purification Of Leucine Amino Peptidase (Lap) In Patients Wiith Diabetic Nephropathy
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Leucine aminopepotidase (LAP)[EC:3.4.11.1] activity has been assayed in (50) serum samples of patients with diabeties naphrophathy D.N (non-insulin dependent diabetic (NIDD) , and (50)serum sample of healthy individuals without any clinically detectable diseases have been as control group. The aim of this study is to measure leucine aminopeptidase activity and partially purifying the enzyme from sera of patients with diabetes nephropathy The results of this study revealed that Leucine aminopeptidase (LAP) activity of nephropathy patient’s serum shows a high signifiacant increase (p < 0.001) compared to that of the healthy subjects.LAP was purified from the serum of patients with diabetes nephropathy by dialysis and gel filtration (Se

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Publication Date
Wed Dec 01 2021
Journal Name
International Medical Journal
Effect of Accelerated Canine Retraction by Vitamin D3 Local Administration on Apical Root Resorption, Alveolar Bone Integrity, and Chair-side Time: A Prospective Clinical Study.
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Objectives: To evaluate the effect of vitamin D3 local injections on apical root resorption, alveolar bone integrity, and chair-side time following three and six months of canine retraction. Subjects and Methods: Seventeen adult patients (18-35 years old) of class I and II malocclusions were recruited, who required bilateral maxillary 1st premolars extraction before starting maxillary canines retraction. The experimental side received 25 pg dose of vitamin D3 injected locally into the distal periodontal sulcus of the canine (before force application) every three weeks, while the control side received retraction force only. Periapical radiographic evaluation was conducted after 3 and 6 months of the start of canines' retraction. Results: At

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Publication Date
Sat May 14 2022
Journal Name
Oral And Maxillofacial Surgery
Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ &lt; 6.0 mm. A prospective clinical study
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