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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
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Genotoxicity of the Aerial Parts of Iraqi Euphorbia cyathophora on Bone Marrow and Spleen Cells in Mice
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The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice  200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Histological and immunohistochemical evaluation of the effect of local exogenous application of VEGF on bone healing (experimental study in rat)
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Background: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this study. This study aimed to identify the role of local exogenous vascular endothelial growth factor in bone healing and to analyze the expression of VEGF by immunohistochemistry in created bone defect af

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Publication Date
Sun Jun 02 2024
Journal Name
Methods And Objects Of Chemical Analysis
Simultaneous Spectrophotometric Determination of Piroxicam, Naproxen, Diclofenac Sodium and Mefenamic Acid in Pharmaceutical Formulations by Partial Least Squares Method
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A chemometric method, partial least squares regression (PLS) was applied for the simultaneous determination of piroxicam (PIR), naproxen (NAP), diclofenac sodium (DIC), and mefenamic acid (MEF) in synthetic mixtures and commercial formulations. The proposed method is based on the use of spectrophotometric data coupled with PLS multivariate calibration. The Spectra of drugs were recorded at concentrations in the linear range of 1.0 - 10 μg mL-1 for NAP and from 1.0 - 20 μg mL-1 for PIR, DIC, and MEF. 34 sets of mixtures were used for calibration and 10 sets of mixtures were used for validation in the wavelength range of 200 to 400 nm with the wavelength interval λ = 1 nm in methanol. This method has been used successfully to quant

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Reasons for Partial Compliance and Non-compliance to the Routine Childhood Vaccination Schedule in Al-Karkh District
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Abstract

      Objective (s): To evaluate reasons for partial compliance and non-compliance to the

                              routine childhood vaccination schedule in Al-Karkh district 

Methodology: Descriptive study , using the evaluation approach, is carried throughout the present study to determine the reasons for the Routine Childhood Vaccination at  health care sectors and primary health care centers at  Al-Karkh District in Baghdad City, Convenient, non-probability, sample of (90) mother who are recruited from health care sectors at Al-Karkh District in Baghdad City. All mothers, who ha

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Publication Date
Tue Dec 05 2023
Journal Name
Engineering, Technology & Applied Science Research
The Fire Effect on the Performance of Reinforced Concrete Beams with Partial Replacement of Coarse Aggregates by Expanded Clay Aggregates
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This paper aims to investigate the flexural behavior of reinforced concrete beams considering fire resistance by adding Lightweight Expanded Clay Aggregates (LECA) to the concrete mix as partial coarse aggregate replacement. LECA is a type of porous clay with a uniform pore structure with fine, closed cells and hard, tightly sintered skin. The experimental work comprised four reinforced self-compacted concrete beams. All the specimens were identical in their geometrical layout of 1600×240×200 mm, reinforcement details, and support condition (simply supported). For all the beams, the main reinforcement was provided by two bars, each having a diameter of 12 mm, while a bar of 6 mm diameter was employed for the top and shear reinforc

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Publication Date
Sat Nov 16 2019
Journal Name
Journal Of Global Pharma Technology
Partial purification of leucine aminopeptidase and its correlation with some biochemical parameters in sera of subclinical hyperthyroidism and hyperthyroidism patients.
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he study aimed to purify of Leucine aminopeptidase (LAP) from sera of hyperthyroidism patients and its relation to some thyroid hormones (TSH, T 3 , T 4 ) of subclinical hyperthyroidism and hyperthyroidism patients with lipid peroxidation levels that may be play a role in this diseases. Specimens were collected during the time from Nov 2017 until Jan 2018 from Endocrine and Diabetes Center, blood samples were collected from fifty healthy control and one hundred patients, patients were divided into two groups consisted of (50) with hyperthyroidism and (50) with subclinical hyperthyroidism. The aged for all subjects ranged (15-60) years with body mass ranged ((25- 29) kg/m 2 . The purification is done by addition of ammonium sulfate, dial

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Publication Date
Tue Jan 18 2022
Journal Name
Materials Science Forum
Effect Partial Substitution of Calcium by <i>Cadmium</i> on Dielectrically Properties of Li0.4Cd0.6Ba2Ca2Cu3O10+δ System
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In this article the conventional "solid-state reaction" method was used to synthesize perovskite Li0.4Cd0.6Ba2Ca2Cu3O10+δ. Four main types of compounds were obtained by physically replacing calcium oxide with cadmium in proportions 0, 0.03, 0.06 and 0.09, the pure Li0.4Cd0.6Ba2Ca2Cu3O10+δ phase, and the phases Li0.4Cd0.6Ba2Ca1.97Cd0.03Cu3O10+δ

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Cone Beam Computed Tomography in an Evaluation and Diagnosis of Anatomical Variations and Pathological Lesions in Maxillary Sinus Prior to Maxillary Sinus Lift Surgery
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Abstract: Thorough assessment of the Maxillary,Sinus is very important. Recently 3-dimensional imagewith Cone Beam Computed Tomography (CBCT) is very dependable in Maxillary Sinus diagnosis. The aim of this study is to: shade light on the role of (CBCT) diagnosis of the maxillary sinus anatomical variation and pathological finding among smokers and nonsmokers prior to maxillary sinus lift techniques. Materials and Method: In this study 60 males with age ranged between 20-50 years old, referred for (CBCT) assessment of maxillary sinus in the Specialist Health Center of AL-Sadder city. The scanning were performed using Kodak 9500 (CBCT), the KV was 90, mA10 and scanning time 10 s. Voxel size 0.3mm with( DICOM ) software on a multiplaner re

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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
On Comparison Study between Double Sumudu and Elzaki Linear Transforms Method for Solving Fractional Partial Differential Equations
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        In this paper, double Sumudu and double Elzaki transforms methods are used to compute the numerical solutions for some types of fractional order partial differential equations with constant coefficients and explaining the efficiently of the method by illustrating some numerical examples that are computed by using  Mathcad 15.and graphic in Matlab R2015a.

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Publication Date
Wed Nov 11 2020
Journal Name
Journal Of Research In Medical And Dental Science
Effect of Topical Melatonin Application on the Peri-Implant Proximal Bone Level and Cortical Plate Thickness (Pilot Clinical Trial)
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