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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
Mon Mar 04 2024
Journal Name
Journal Of Emergency Medicine, Trauma And Acute Care
Cone beam computed tomography (CBCT) evaluation of ridge shape and bone density in Iraqi sample pre-dental implant insertion
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One of the critical factors for dental implant success is accurate clinical and radiological assessment. Cone-beam computed tomography systems (CBCT) allow surgeons to determine the quality and quantity before surgery, aiding in treatment planning. This study highlights the importance of such an assessment Materials and Methods A total of 40 patients were referred to CBCT scanning for pre-dental implant assessment in the Oral and Maxillofacial Radiology department at Al-Shaheed Gazi Al Hariri Hospital from 2021 to 2022. The patients were between 18 and 50 years old. All data were analyzed with on-demand 3D software (Kavo OP 3D: Cone Beam 3D imaging Germany). Results: Regarding the ridge shape: In the upper anterior and posterior regions, th

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Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Evaluation the Effect of 805 nm Wavelength Diode Laser on Repair of Mandibular Bone Repair and Skin Incisions in Rabbits
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The long healing time of bone after tooth extraction in order to construct artificial teeth is uncomfortable to the patient because of aesthetic or masticatory problems in addition to the daily visit to dental clinic. The objective of this study was to evaluate the effect of 805 nm diode laser with long time intervals on repair of bone and skin incisions in rabbits through biochemical, radiological and histological findings. Eighteen New-Zealand rabbits were undergone surgical operations to make a cavity in the bone of the lower jaw, the rabbits were divided into two groups:- Group A (control group) containing nine rabbits. Group B (lased group) containing nine rabbits in which two cavities were done, one on the right side and the other

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Publication Date
Sun Jun 21 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Incidence of Genotoxic Effects of Artificial Food Favoring Additives in Bone Marrow Cells and Spleen Cells in Mice
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Genetic material is the most important component of cells because it contains the genetic information; hence any disruption to the structure chromosome of cells could lead to very bad results. Genotoxicity use to evaluate the safety of any chemical compounds on genetic materials. Artificial food flavoring additive are chemical substances to produce specific placebo effects added to foods but impart specific flavor to it.

The present study evaluates the genotoxic effect of artificial food flavoring additive on structure of chromosomes at three different concentrations (50%, 100%and 150%) on both bone marrow cells and spleen cells in mice for fourteen successive days. It was found that artificial food flavoring addit

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Impact of omega 3 alone or in combination with irinotecan on bone marrow and spleen of rats: in vivo study
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Abstract

Objectives: The present study designed to explore the genotoxicity through measurement of Mitotic index in bone marrow and the spleen cells, as possible mechanism of bone marrow and spleen toxicity that induced by irinotecan; and to describe the protective actions of omega 3 against irinotecan induced genotoxicity in bone marrow and the spleen of rats.

Methods: Twenty four (24) rats (Sprague-Dawley) were randomly divided into four groups: Group Ӏ, rats  received single oral daily dose of distilled water (2 ml/kg) for 25 days (negative control group); Group ӀӀ (irinotecan-treated), receiv

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Publication Date
Mon Dec 20 2021
Journal Name
Journal Of Craniofacial Surgery
The Effect of Bone Density Measured by Cone Beam Computed Tomography and Implant Dimensions on the Stability of Dental Implants
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Abstract: The aim of this study was to evaluate the effect of bone density value in Hounsfield unit derived from cone beam computed tomography (CBCT), and implant dimensions in relation to implant stability parameters namely the resonance frequency analysis and the insertion torque (IT) value. It included 24 patients who received 42 dental implants (DI). The bone density of the planned implant site was preoperatively measured using cone beam computed tomography. The implant stability was measured using Osstell implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. The IT value was categorized as 35 N/cm or > 35 N/cm. The mean (standard deviation) primary stability was 79.58 (5.27) ISQ,

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of AcceleDent® Device on Both Gingival Health Condition and Levels of Salivary Interleukin-1-βeta and Tumor Necrosis Factors-Alpha in Patients under Fixed Orthodontic Treatment
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Background: Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva.The purpose of this study was to evaluate the activity of alkaline phosphatase (ALP) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces. Materials and Methods: Thirty orthodontic patients (12 males and 18 females) aged 17-23 years with class II division I malocclusion all requiring bilateral maxillary first premolar extractions were randomly divided into three groups according to t

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Buccal Cortical Bone Thickness in Iraqi Arab Adults by Cone Beam Computed Tomography for Orthodontic Mini-Implants
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ABSTRACT Background: Cortical bone thickness is important for the stability of mini implants. Placing mini implants in sites of favorable cortical bone thickness would guarantee better initial stability and long-term success. The aim of this study was to investigate gender, side and jaw differences of the buccal cortical bone thickness as a guide for orthodontic mini screw placement. Materials and Methods: The sample was selected from the patients attending the Specialized Health Center in Al-Sadr City / 3D department. Thirty patients (15 males and 15 females) were selected and cone beam computerized tomographic images were done. Then the buccal cortical bone thickness was measured at thirteen inter radicular sites in the maxilla and mandib

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Evaluation of the Possible Protective Effect of Fisetin against Cyclophosphamide-induced Genotoxicity in Bone Marrow and Spleen Cells of Male Rats
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Fisetin is a plant flavonoid found in strawberries and other fruits and vegetables such as apples, persimmons, and onions. It has many pharmacological effects like anti-inflammatory, antioxidant, cardioprotective, neuroprotective, and anti-carcinogenicity which are attributed to its ability to reduce oxidative stress which considers the main reason for different disease conditions. Genotoxicity refers to the genetic material destruction within the cell which can be caused by different chemicals as well as radiation. The present study evaluates the effect of orally-administered fisetin daily for seven constitutive days on genotoxicity induced by cyclophosphamide in rats’ bone marrow and spleen cells. Results showed that fisetin exh

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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Genetic Analysis by Using Partial Diallel Crossing of Maize In High Plant Densities (Estimation GCA, SCA and Some Genetic Parameters)
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Abstract<p>The experiment was carried out at the Field Crops Research Station, College of Agricultural Engineering Sciences - University of Baghdad in Jadiriyah, with the aim of evaluating the performance of partial diallel hybrids and inbred lines of maize and estimating general combining ability(GCA), specific combining ability (SCA) and some genetic parameters. The experiment was carried out in two seasons, spring and fall 2020. Eight inbred lines of maize were used in the study (BI9/834, BSW18, LW/5 L8/844, ZA17W194, Z117W, ZI17W9, ZI7W4), numbered (1,2,3,4,5,6,7,8), It was sowed in the spring season and entered into a cross-program according to a partial diallel crossing system to obtain tw</p> ... Show More
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Publication Date
Mon Jul 24 2023
Journal Name
Research Journal Of Pharmacy And Technology
Comparison of the effects of Methotrexate and Etanercept on RANKL and OPG as Bone Metabolism Biomarkers in patients with Rheumatoid Arthritis
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Rheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The

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