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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
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
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
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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 difficultie

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Crossref
Publication Date
Tue Nov 05 2019
Journal Name
Cardiff University
Technology development for nanoscale InSb quantum split-gate structures
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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
On the Split Mersenne and Mersenne-Lucas Hybrid Quaternions
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In this communication, introduce the split Mersenne and Mersenne-Lucas hybrid quaternions, also obtaining generating functions and Binet formulas for these hybrid quaternions and investigating some properties among them.

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Publication Date
Mon Nov 06 2023
Journal Name
Eneurologicalsci
Dandy-Walker syndrome associated with a giant occipital meningocele: A case report and a literature review
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HTH Ahmed Dheyaa Al-Obaidi,", Ali Tarik Abdulwahid', Mustafa Najah Al-Obaidi", Abeer Mundher Ali', eNeurologicalSci, 2023

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Scopus (3)
Scopus
Publication Date
Sun Sep 07 2025
Journal Name
Alqalam Journal Of Medical And Applied Sciences
Atypical Presentation of Fibroepithelioma of Pinkus: A Case Report and Review of the Literature
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Fibroepithelioma of Pinkus (FEP) is a slowly growing, low-grade malignant tumor with very low metastatic potential that is considered a distinct variant of basal cell carcinoma (BCC). It usually manifests as sessile or polypoidal lesions on the trunk of middle-aged patients. However, it may present in younger age groups, even in children. In this case, we present a rare case of FEP atypically presenting as a scaly plaque on the lower back for several years in an elderly female who was eventually diagnosed by excisional biopsy and histopathology.

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Publication Date
Sun Jul 24 2022
Journal Name
Healthcare
Incidence of Gingival Black Triangles following Treatment with Fixed Orthodontic Appliance: A Systematic Review
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This systematic review aimed to investigate the relation between orthodontic treatment (OT) and the incidence of the gingival black triangle (GBT) after completing treatment with a fixed orthodontic appliance, as well as the associated risk factors and the level of alveolar bone. Electronic and hand searches were conducted in three electronic databases for relevant articles published up to March 2022. Retrieved articles went through a two-step screening procedure, and the risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists. The incidence of GBT after OT was set as the primary outcome, while the secondary outcomes were the risk factors associated with GBT and alveolar bone loss following OT. Out of 421 papers, 5

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Appearance and Decay of Split-brain Theory to Explain Human Artistic Activity: A Historical Review: بدر محمد المعمري
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Nearly, in the middle of 1970s the split-brain theory became the only theory that explains human creativity used in all fine art and art education schools. In fact, this theory- which appeared for first time in the middle of 1940s – faced many radical changes including its concepts and structures, and these changes affected both teaching art and art criticism. To update people awareness within art field of study, this paper reviews the split-brain theory and its relationship with teaching art from its appearance to its decay in 2013 and after.

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Crossref
Publication Date
Wed Feb 08 2023
Journal Name
Eneurologicalsci
Double encephalocele with an excellent outcome postoperatively: A case report from Iraq
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HTH Ali Tarik Abdulwahid , Ahmed Dheyaa Al-Obaidi , Mustafa Najah Al-Obaidi, eNeurologicalSci, 2023

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Scopus (3)
Scopus
Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Oral And Maxillofacial Surgery
Pain Reduction in Extensive Apical Surgery of the Anterior Maxilla: A Comparative Clinical Study
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