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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 Jan 01 2016
Journal Name
European Journal Of Biology And Medical Science Research
Impact of an educational intervention of training of breast feeding promoting on the knowledge and attitude of a sample of mothers: a study of a pre and post evaluation.
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Background: Health professionals have a crucial role in promotion, support and management of breastfeeding. To be effective in this effort, the clinician should focus on the issue from the preconception stage through pregnancy and delivery, and continue in subsequent infant care. Aim of the study: to assess the effectiveness of the UNICEF/WHO 40-hour of breast feeding training through the assess breastfeeding knowledge and attitudes of the health profession staff before and after training course.

Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
A 4-Day Plaque-Regrowth Anti-Plaque Effect of a Combination of Green Tea and Salvadora Persica L.: A Randomized Controlled Crossover Clinical Trial
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
A political perusal of Initiations in Declaring Middle East a District vacant of mass Destruction weapons
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A political perusal of Initiations in Declaring Middle East a District vacant of mass Destruction weapons

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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Modern Project Management
THE IMPACT OF STRATEGIC INTELLIGENCE ON ORGANIZATIONAL PERFORMANCE: A TEXTILE SECTOR PERSPECTIVE OF A DEVELOPING ECONOMY
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In today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio

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Publication Date
Fri Nov 01 2024
Journal Name
Journal Of Kufa Legal And Political Science
The Legal Regime of Mandatory Mediation as a Means of Dispute Resolution – A Comparative Analytical Study
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The mediation system is based on settling the dispute amicably through the intervention of a third party by bringing views closer away from the judiciary, which is an amicable way to settle disputes, which disputants resort to voluntarily, but some Western legislation has begun to impose resorting to mediation to settle disputes compulsorily, to take advantage of its advantages, get rid of the disadvantages of resorting to the judiciary in some disputes, and relieve pressure on the courts.

Publication Date
Sun Jul 01 1990
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
CHALCIDOID (HYMENOPTERA.) PARASITES OF THE BRUCHID BEETLES IN IRAQ WITH A DESCRIPTION OF A NEW SPECIES)
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The present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Building a Reliable Steganography System Using Random Key in a spatial Domain of Image
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With time progress importance of hiding information become more and more and all steganography applications is like computer games between hiding and extracting data, or like thieves and police men always thieve hides from police men in different ways to keep him out of prison. The sender always hides information in new way in order not to be understood by the attackers and only the authorized receiver can open the hiding message. This paper explores our proposed random method in detail, how chooses locations of pixel in randomly , how to choose a random bit to hide information in the chosen pixel, how it different from other approaches, how applying information hiding criteria on the proposed project, and attempts to test out in code, and

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Publication Date
Mon Jun 01 2015
Journal Name
المؤتمر العلمي التخصصي الحادي والعشرون لكلية التربية/ الجامعة المستنصرية 22-23 نيسان 2015 الفيزياء
Computer Simulations of Imaging a Dirac Delta Function by a Ground-Based Optical Telescope
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Two- dimensional numerical simulations are carried out to study the elements of observing a Dirac point source and a Dirac binary system. The essential features of this simulation are demonstrated in terms of the point spread function and the modulation transfer function. Two mathematical equations have been extracted to present, firstly the relationship between the radius of optical telescope and the distance between the central frequency and cut-off frequency of the optical telescope, secondly the relationship between the radius of the optical telescope and the average frequency components of the modulation transfer function.

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Publication Date
Fri Jun 03 2022
Journal Name
Military Medical Science Letters
COVID-19 AMONG A SAMPLE OF IRAQI PATIENTS WITH RHEUMATIC DISEASES: A MULTICENTER STUDY
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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The martial rights and duties (Rights and duties of a woman and a man)
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This research addresses the relevance of men and women and the consequent provisions
such as dowry and alimony ... Of the like, marriage is to organize links masculinity and
femininity any sexual meeting between men and women a special system that must be
produces reproduction him and alone, which gets its reproduction in human kind, and has no
family and on the basis of private life is being organized.
The importance of the topic see Islam has urged marriage and forbade celibacy, and ensure
that the Lord of Glory Almighty married subsidy nor the origin of the differences between
men and women in money or workmanship or blue-chip Every Muslim inept any Muslim and
every Muslim efficient for any Muslim.
The impor

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