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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
Fri Jun 30 2023
Journal Name
Pakistan Heart Journal
Music Medicine Intervention--Based Program for Reducing Pain and Anxiety of Children Undergoing Bone Marrow Aspiration and Lumber Puncture Procedures
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Publication Date
Thu Oct 02 2014
Journal Name
Basrah Journal Of Science
Extraction and partial purification for fimbriae from Proteus mirabilis and study their role in adhesion to uroepithlial cells
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From 211 urine samples, Gram negative bacteria were isolated from only 61 urine samples with isolation percentage 28.9%. Escherichia coli were isolated percentage 70.49% while Klebsiella pneumoniae and Psendomonas aeruginosa were 8.19% and 6.55%, respectively.Proteus spp. Were isolated from 9 (14.75%), P. mirablis and P. vulgaris were isolates percentage 11.47% and 3.27%, respectively. Uroepithelial Cell Adhesin (UCA) fimbriae expression by P.mirabilis isolates was detected by the high capacity to adhesion to human uroepithetial cells, the isolate p.mirabilis U7 was adhesion to human uroepithelial cells mean no.30.2 bacteria/cell when grown on luria broth at 37C for 24h, but then grown it’s on luria agar at 37C for 24h the adhesion

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Publication Date
Tue Jan 25 2011
Journal Name
Journal Of Cellular Biochemistry
Phytoestrogens directly inhibit TNF-α-induced bone resorption in RAW264.7 cells by suppressing c-fos-induced NFATc1 expression
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TNF-α-induced osteoclastogenesis is central to post-menopausal and inflammatory bone loss, however, the effect of phytoestrogens on TNF-α-induced bone resorption has not been studied. The phytoestrogens genistein, daidzein, and coumestrol directly suppressed TNF-α-induced osteoclastogenesis and bone resorption. TRAP positive osteoclast formation and resorption area were significantly reduced by genistein (10(-7) M), daidzein (10(-5) M), and coumestrol (10(-7) M), which was prevented by the estrogen antagonist ICI 182,780. TRAP expression in mature TNF-α-induced osteoclasts was also significantly reduced by these phytoestrogen concentrations. In addition, in the presence of ICI 182,780 genistein and coumestrol (10(-5) -10(-6) M) augmente

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Scopus
Publication Date
Tue Jun 02 2020
Journal Name
Diyala Journal Of Medicine
Histological and Immunohistochemical Study of Osteocalcin to Evaluate The Effect of Local Application of Symphytum Officinale Oil on Bone Healing on Rat
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Background: The repair of bone defects remains a major clinical challenge in dentistry. Bone is a highly vascularized tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. The health promotive , preventive, and curative properties of herbs were recognized by the ancient and the present pharmacist and physicians to form the theoretical foundations in Medicine. Objective: Immunohistochemistry of osteocalcin and histological study to prove that symphytum officinale oil when applied locally on generated bone defect healing in rat tibia, it was very effectiveness. Patients and Methods: 0ur study fourty male rats , weighting (250-350) grams ,aged (5 7)months ,was

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Crossref (5)
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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical Of Cellular Archieves
HISTOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF OSTEOCALCIN TO EVALUATION THE EFFECT OF LOCAL APPLICATION OF LEPIDIUM SATIVUM OIL ON BONE HEALING ON RAT
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ABSTRACT : The restoration of bone continuity and bone union are complex processes and their success is determined by the effectiveness of osteosynthesis. The use of plants for healing purposes predates human history and forms the source of current modern medicine. This research was planned to study the histological and immunohisto-chemistry of osteocalcin to evaluate of effect of local application of lepidium sativum oilon healing of induced bone defect in rat tibia. In this study, fourty albino male rats, weighting (300-400) gram, aged (6-8) months, will be used under control conditions of temperature, drinking and food consumption. The animals will subject for a surgical operation of medial side of tibiae bone, in control group the bone

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Scopus (2)
Scopus
Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Preparing the Arabic Language Teacher for Non-Native Speakers, Following the Experience of the Arabic Language Institute at the International University of Africa: منى يوسف محمَّد وقيع الله
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The study aims to examine the reality of preparing the Arabic language teacher for non-native speakers by presenting the experience of the Arabic Language Institute at the International University of Africa. Thus, it addresses the following questions: How is it possible to invest the long scientific experiences in proposal and experiment preperations to qualify Arabic language teachers for non-native speakers? What is the reality of preparing an Arabic language teacher at the Institute? How did the Arabic Language Institute process teacher preparation? What are the problems facing the preparation of the Arabic language teachers and the most important training mechanisms used in that Institute?What problems faced the implementation of the

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Publication Date
Thu Dec 01 2016
Journal Name
Al.qadisiya Journal For The Sciences Of Physical Education
Comparing self-learning associated with the model and learning reverse fashioned way of partial way to learn Olympic lifts for beginners
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Abstract The purpose of this study, teach the art of performing Olympic lifts (snatch and, clean and jerk) using the two methods are instructional (self-learning associated with the model) and (reverse style of partial way). Identify the effectiveness of these methods in learning the art of performance and style of the best Olympic lifting in the learning and retention of novice for Olympic lifts. The research sample consisted of 16 lifters were selected purposively representing specialist center for the care of athletic talent to weightlifting for ages 14 years. The sample was divided into two experimental, Each group (8) eight weightlifters. The experimental group used the style of the first self-learning associated with the m

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Thickness of Buccal Bone at Various Sites of the Mandible and Its Clinical Significance in MonocorticalScrews Placement Using Multi-Slice Computed Tomography
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Background:Open reduction and internal fixation (ORIF) of using miniplates and screws is the treatment of choice of mandibular fractures. It is important to know both: the region where the bone providesafirm anchorage, andthe topography of the dental apices and inferior alveolar nerve to avoiddamaging them when inserting the screw. The aim of this study is to determine the thickness of buccal cortical plate and that of buccal bone at the parasymphysis and mandibular body, thereby determining the area that provide afirm anchorage and the maximum length of mono-cortical screws that can be safely placed in these regions without injuring the tooth roots or mandibular nerve. Materials and Methods:The sample of the present study was 110 Iraqi sub

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Publication Date
Tue Oct 04 2022
Journal Name
Cureus
The Impact of Angiotensin Converting Enzyme-2 (ACE-2) on Bone Remodeling Marker Osteoprotegerin (OPG) in Post-COVID-19 Iraqi Patients
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Crossref (6)
Clarivate Crossref
Publication Date
Mon Jan 01 2007
Journal Name
Iraqi Journal Of Agricultural Sciences
EVALUATION OF PARTIAL AND COMPLETE REPLACEMENT OF SOYBEAN MEAL BY FERMENTEED BROAD BEAN IN THE DIET OX THE PRODI ICTIVR PERFORMANCE OF BROILERS
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AAA AL-NUAIMY, MH ABDLL-ABASS, Iraqi Journal of Agricultural Sciences, 2007

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