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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 Dec 13 2020
Journal Name
Clinical And Experimental Dental Research
The efficacy of polyether‐ether‐ketone wire as a retainer following orthodontic treatment
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Abstract<sec><title>Objectives

To investigate the efficacy of polyether‐ether‐ketone (PEEK) wire as a fixed orthodontic retainer, by comparing its performance to other retainer wires and optimizing its adhesion to composite bonding materials.

Materials and methods

Retainer wires of 15 mm segments were used, PEEK wires were prepared in cylindrical form with 0.8 mm diameter, and had two surface treatments namely air‐abrasion and conditioning with adhesive system. Three different metallic retainer wires were used for comparison and three tests were performed; two tests measured debonding force and associated wire deflec

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of South Asian Federation Of Obstetrics And Gynaecology
Effect of Leptin Level in Pregnancy Complicated by Preeclampsia and Pregnancy Outcome
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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
Minimal sternotomy surgery in comparison to standard sternotomy in the coronary bypass Surgery
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Background Median sternotomy is the gold standard incision for most cardiac operations. However, with the advent of minimal invasive surgery, a new approach emerged in cardiac surgery named mini-sternotomy and has been successfully used to perform a variety of operations.

 The aim of this paper is to present our experience of using mini-sternotomy to harvest the left internal mammary artery (LIMA) for off-pump revascularization of the left anterior descending artery (LAD)

 Methodology Over a 2-year period (October 2012-October 2014), 100 patients underwent coronary artery bypass grafting (CABG) via conventional median sternotomy (CMS) (n=80) and mini-sternotomy (MS) (n=20). The

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Publication Date
Fri Oct 28 2022
Journal Name
Surgical Neurology International
Extracranial carotid localized fibromuscular dysplasia: A case report and literature review
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Background:

Fibromuscular dysplasia (FMD) is a noninflammatory and nonatherosclerotic arteriopathy that is characterized by irregular cellular proliferation and deformed construction of the arterial wall that causes segmentation, constriction, or aneurysm in the intermediate-sized arteries. The incidence of FMD is 0.42–3.4%, and the unilateral occurrence is even rarer. Herein, we report a rare case of a localized extracranial carotid unilateral FMD associated with recurrent transient ischemic attacks (TIAs) treated by extracranial-intracranial bypass for indirect revascularization. The specific localization of the disease rendered our case unique.

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Publication Date
Wed Apr 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparative Study of Clinicopathological and Immunohistochemical Expression of CD1a, RANK and RANKL in Langerhans Cell Histiocytosis of Jaw and Skull Lesions
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Background: Langerhans' cell histiocytosis (LCH) is a group of conditions affecting the reticuloendothelial system. It includes Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma and most often presents in childhood. Materials and methods: Twenty-five cases of LCH were diagnosed histologically and confirmed by CD1a antibody and assessed immunohistochemically using anti-RANKL and anti-RANK antibodies to evaluate osteoclastogenic mechanism. Results: Regarding jaw cases, there was a significant correlation between CD1a and RANK (P=0.016). While in the skull, highly significant correlation existed between RANK and RANKL (p=0.001). Among the sites, there was no statistically significant difference found for each

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Publication Date
Thu Sep 03 2020
Journal Name
Al-kindy College Medical Journal
Unusual Location of Giant Cell Tumor of the Tendon Sheath .. A Case Report
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Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

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Publication Date
Thu Sep 03 2020
Journal Name
Al-kindy College Medical Journal
Unusual Location of Giant Cell Tumor of the Tendon Sheath .. A Case Report
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Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)
Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

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Publication Date
Mon Jun 03 2019
Journal Name
Al-kindy College Medical Journal
A Case Report -Bilateral Giant Achilles Tendon Xanthomas Resection with a Tendon transverse Technique
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Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition. Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected. There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficulties. It has been suggested that total resection with au

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Publication Date
Fri Aug 26 2022
Journal Name
Surgical Neurology International
Excellent recovery after nonmissile penetrating traumatic brain injury in a child: A case report
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Background:

Nonmissile penetrating traumatic brain injuries (pTBIs) are low-velocity injuries which can be caused by a variety of inflicting tools and represent a rare entity in children. Poor outcome has been attributed with an initial admission Glasgow Coma Scale (GCS) of <5, asymmetrical pupil size, and specific initial computed tomography scan findings including brainstem injury.

Case Description:

We report a case of an 11-year-old boy who presented to our ER with a GCS of 6 after being assaulted on his head by a 30 cm length metallic tent hook penetrating his forehead reaching down to the central skull bas

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
A Case Report -Bilateral Giant Achilles Tendon Xanthomas Resection with a Tendon transverse Technique
...Show More Authors

Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition.

Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected.

There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficultie

... Show More
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