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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 Oct 15 2023
Journal Name
Bionatura
Study of the Effect of Diabetes Mellitus I on Bone Mineral Density of Upper and Lower Limbs by Dual-Energy X-Ray Absorptiometry
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Background: Bone mineral density (BMD) has been assessed using Dual-Energy X-ray absorptiometry (DEXA). This procedure is considered to be of vital importance in assessing the general condition of individuals concerning their skeletal mineralization. BMD is measured according to the results of the DEXA examination of the vertebral column and pelvis. Although diabetes mellitus (D.M.)is known to affect BMD, the information regarding this relationship is not currently particularly clear. Objective: This study concentrates on the point that the assessment of BMD for the vertebral column is insuffi-cient to give a realistic and correct picture of the mineralization of the remaining part of the skeleton. Besides, this study elicited a gen

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Bone density determination for the maxilla and the mandible in different age groups by using computerized tomography (Part I)
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Background: Mini implant stability is primarily related to local bone density; no studies have evaluated bone density related to mini implant placement for orthodontic anchorage between different age groups in the maxilla and the mandible. The present research aims to evaluate side, gender, age, and regional differences in bone density of the alveolar bone at various orthodontic implant sites. Materials and method: Fifty three individuals who were divided into two groups according to their age into: group I (ages 16-20 years) and group II (ages 21-29 years) had subjected to clinical examination, then 64-multislice computed tomography scan data were evaluated and bone density was measured in Hounsfield unit at 102 points (51 in the maxilla

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
The influence of partial substation of antimony & lanthanum oxides on electrical and structural properties for the superconductor compound Bi2-xSbxBa2Ca2-yLayCu3O10+δ
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Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
Improvement the Superconducting properties of TlBa2 Ca2 Cu3xNix O 9-δ superconducting compound by partial substitution of copper with nickel oxide on the
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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Studying the partial substitution of barium with cadmium oxide and its effect on the electrical and structural properties of HgBa2Ca2Cu3O8+δ superconducting compound
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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of gender, age and tooth loss on the dimensions of incisive canal, and buccal bone anterior to the canal (Computed Tomography study)
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Background: The incisive canal is an anatomical structure with an important location in the anterior maxilla, analyzing this canal and its relation to the bone anterior to the canal is necessary during dental implant. Aim of this study is evaluated effect of gender, age and tooth loss in area of maxillary central incisors teeth on the dimensions of incisive canal and buccal bone anterior to the canal using spiral computed tomography. Materials and Methods: Sample consists of prospective study for 156 subjects for both gender, they divided into two groups, 120 dentate group (60 male and 60 female) with age ranging from (20-70) and 36 edentate group (with missing maxillary central incisors) (18 male and 18 female) with age ranging from (50-70

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Publication Date
Wed Dec 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of autologous bone marrow-derived stem cells with estimation of molecular events on tooth socket healing in diabetic rabbits (Immunohistochemical study)
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Background: Healing of a tooth extraction socket is a complex process involving tissue repair and regeneration. It involves chemotaxis of appropriate cells into the wound, Transformation of undifferentiated mesenchymal cells to osteoprogenitor cells, proliferation and differentiation of committed bone forming cells, extracellular matrix synthesis, mineralization of osteoid, maturation and remodeling of bone. These cellular events are precisely controlled and regulated by specific signaling molecules. Some of these like transforming growth factor beta (TGF-?), vascular endothelial growth factor (VEGF), bone morphogenetic proteins (BMP) and insulin like growth factors (IGF) are well conserved proteins involved in the initial response to injur

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Association between Allelic Variations of -174G/C Polymorphism of Interleukin-6 Gene and Chronic Kidney Disease-Mineral and Bone Disorder in Iraqi Patients
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This study designed to examine association between-174G/C polymorphism of interleukin-6 gene and phosphate, calcium, vitamin D3, and parathyroid hormone levels in Iraqi patient with chronic kidney disease on maintenance hemodialysis. Seventy chronic renal failure patients (patients group) and 20 healthy subjects (control group) were genotyped for interleukin-6 polymorphism and genotyping was performed by conventional polymerase chain reaction-restriction fragment length polymorphism. No significant differences in phosphate levels were observed in patients and control with different interleukin-6 genotypes. Control had non-significant differences in calcium levels, while patients with GG and CG genotypes displayed significant e

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Publication Date
Wed Dec 03 2025
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 5, 2022, Págs. 275-278
The effect of therapeutic physical exercises in the rehabilitation of the knee joint injured partial rupture of the medial meniscal cartilage for football players
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Autorías: Ismael Saleem Abed, Imad Kadhim Khlaif, Salah Mahmood Salman. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 5, 2022. Artículo de Revista en Dialnet.

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Arthroscopic micro fracture and intra articular whole bone marrow injection for the treatment of articular cartilage lesions in the knee joint. Authors
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Abstract Background: Articular cartilage lesions in the knee joint are frequently seen,its treatment represents a challenge for orthopedic surgeons especially in young age patients and if left untreated,then they can progress to advanced osteoarthritis that may affect the functional status of the patients.Many treatment modalities had developed for these lesions, in the current study arthroscopic micro fracture plus intra articular whole bone marrow(WBM) injection was used as modality of treating these lesions. Objectives: to assess the effectiveness of arthroscopic micro fracture plus WBM intra articular injection as a treatment modality for knee articular cartilage lesions. Patients and Methods : a prospective experimental study was perf

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