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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
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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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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Publication Date
Sun Jun 22 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
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
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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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
Sun Jun 22 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 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
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
Sun Jun 22 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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