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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 Sep 01 2016
Journal Name
Journal Of Engineering
Effect of Using Porcelanite as Partial Replacement of Fine Aggregate on Roller Compacted Concrete with Different Curing Methods
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Roller-Compacted Concrete is a no-slump concrete, with no reinforcing steel, no forms, no finishing and wet enough to support compaction by vibratory rollers. Due to the effect of curing on properties and durability of concrete, the main purpose of this research is to study the effect of various curing methods (air curing, 7 days water curing, and permanent water curing) and porcelanite (local material used as an Internal Curing agent) with different replacement percentages of fine aggregate (volumetric replacement) on some properties of Roller-Compacted Concrete and to explore the possibility of introducing practical Roller-Compacted Concrete for road pavement with minimum requirement of curing. Specimens were sawed fro

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Publication Date
Thu May 16 2019
Journal Name
Al-khwarizmi Engineering Journal
Study of Transverse and Longitudinal Crack Propagation in Human Bone Using the Finite Element Method with MATLAB
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A finite element is a study that is capable of predicting crack initiation and simulating crack propagation of human bone. The material model is implemented in MATLAB finite element package, which allows extension to any geometry and any load configuration. The fracture mechanics parameters for transverse and longitudinal crack propagation in human bone are analyzed. A fracture toughness as well as stress and strain contour are generated and thoroughly evaluated. Discussion is given on how this knowledge needs to be extended to allow prediction of whole bone fracture from external loading to aid the design of protective systems.

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Measurements of Maxillary Alveolar Bone Density at 13-15 Years Age by Using Spiral Computerized Tomography
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Background: Bone density is a major factor that affect mini implant primarily stability; no Iraqi studies have evaluated bone density related to mini-implant placement for orthodontic anchorage at age 13 -15 years. The present research aims to evaluate gender, side and site differences in the bone density at various orthodontic implant sites for the maxillary alveolar bone. Materials and methods: Twenty nine individuals (16 males and 13 females) had subjected to clinical examination, then 64-multislice computed tomography scan data were evaluated and bone density was measured in Hounsfield unit at 21 points (9 points for each side and 3 points between the right and left central incisors) . Results: The results obtained showed that there ar

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation the effect of hyaluronic acid on bone healing process in rabbits (Immunohistochemical study for TGF-β)
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Background: Bone augmentation techniques are commonly employed in medical fields. This biomaterial system must be readily available, easily applicable by minimally-invasive technique and able to release an osteoinductive growth factor. Such a system will be able to engineer new bone formation locally at the site of injection. Hyaluronic acid has osteogenic potential that can be exploited not only for repairing bone defects but also for providing transplantable bone for the reconstruction of a variety of bone defects. The aims of this study were to evaluate the effects of Hyaluronic acid gel on bone healing by immunohistochemical estimation of transforming growth factor -beta 3 in experimental and control groups. Materials and methods: Thirt

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Publication Date
Wed Aug 10 2022
Journal Name
International Journal Of Biomaterials
Use of Eggshells as Bone Grafts around Commercially Pure Titanium Implant Screws Coated with Nano Calcium Sulfate
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Background. Implant insertion in regions with poor bone quantity, such as the posterior maxilla, is potentially associated with an increased rate of implant failure. Calcium sulfate can be used as the coating material for commercially pure titanium (CpTi) and as the bone graft material around implants when bound to eggshell powder to enhance the bone quality and quantity of bone defect regions. This study performed a torque removal test to evaluate the effectiveness of eggshell powder as a bone substitute for filling bone defects around CpTi-coated implants coated with nanocrystalline calcium sulfate. Materials and Methods. Eighty screw implant designs were used in the tibiae of 20 white New Zealand rabbits. A total of uncoated 20 s

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Publication Date
Fri Dec 15 2023
Journal Name
Iraqi Journal Of Laser
The Reliability of Two Different Laser Wavelengths in Inducing Bone Healing Around Dental Implants: Comparative Clinical Trial
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Background/purpose: Dental implantology involves different treatments that have been used in conjunction with dental implant surgery to increase implant stability and bone regeneration process. Photobiomodulation( PBM) can be one of these techniques. The objective of this study was to evaluate the bone density around implants. Materials and methods: in this study, 10 individuals had 20 implants inserted in the posterior of their mandibles. each patient received two implants the left side served as the control whereas the right side served as the study group with a diode laser (same patients). measurements were made for each implant. Measurements were obtained using cone-

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Success rate of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassyeria cardiac center
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Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
Effect of aqueous and alcoholic extracts of Mushroom Calvatia craniiformis in bone marrow and interferon Gamma in mice
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This research was designed to study the effect of water and alcoholic crude extracts of Calvatia craniiformis in vitro and in vivo On the other hand this study tested the toxic effect of both extracts in normal laboratory mice. The results showed that water and alcoholic extracts relatively have an acute toxic effect in mice in respect to LD50 (85 mg/kg, and 177mg/kg respectively). However the chronic toxicity of water extract at three different concentration (50, 75, 100 mg/kg) and alcoholic extract at concentrations of (100, 150, 200 mg/kg) was investigated in normal mice by (I.P) administration for 30 days alternatively and one drag in 48 hours . The results indicated significant effect (P ? 0.01) increasing in (MI) and (BI) of bone mar

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of Oral Supplementation of Pomegranate Peel Extract on Some serum biochemical Parameters Related with Bone in Rabbit
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Background and aim: Pomegranate is a medicinal herb that can promote healing of periodontal tissue through differentiation of mesenchymal cells both in vivo and in vitro. Therefore, this study is to investigate the effect of oral supplementation of Punicagranatum L. peel extract on bone defect in rabbit. Methods: Forty five male rabbits were divided into 3 groups; group 1; baseline group(5 rabbits) left without bone defect. Group 2; study group (20 rabbits) with bone defect model that received daily 1ml of oral supplementation of pomegranate peel extract (PoPx). Group 3; control group (20 rabbits) with bone defect model that received distilled water. Bone defect was done into facial plate of lower right central incisor. Blood biopsies by

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Publication Date
Sat Jan 01 2022
Journal Name
Iop Conference Series: Earth And Environmental Science
Some Properties of Concrete Containing Waste Brick As Partial Replacement Of Coarse Aggregate And Addition Of Nano Brick Powder
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Abstract<p>The accumulation of construction and demolition waste is one of the major problems in modern construction. Hence, this research investigates the use of waste brick in concrete. Seven different concrete mixes were investigated in this study: a control concrete mix, three mixes with volumetric replacement (10, 20, and 30)% of natural aggregate with brick aggregate, and two mixes with the addition of nano brick powder at a percentage level of 5– 10% by weight of cementitious materials. And the last one was mixed with 10% nano brick and 10% coarse brick aggregate. The experimental results for the additive of nano brick powder showed an enhancement in mechanical properties (compressive, </p> ... Show More
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