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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
Sat May 01 2021
Journal Name
Journal Of Craniofacial Surgery
Barbed Broach in the Maxillary Sinus: A Report of Unusual Complication in Craniofacial Area
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Publication Date
Sun Oct 01 2023
Journal Name
Journal Of Surgical Case Reports
Agenesis of flexor pollicis longus without thenar hypoplasia: a case report and literature review
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Abstract<p>We present a case of congenital of flexor pollicis longus agenesis without thenar hypoplasia in a 12-year-old girl with no history of trauma. Two-staged corrective surgery was planned. In the first stage, the flexor pulley was reconstructed using silicone followed by the second stage 3 months later when flexor pollicis longus reconstruction was performed using tendon transfer of the flexor digitorum superficialis. The patient completed post-operative physiotherapy and the result of the surgical treatment in both functional and cosmetic aspects was, in the authors’ opinion, excellent.</p>
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Scopus (1)
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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Craniofacial Surgery
Evaluation the Efficacy of Hilotherm Cooling System in Reducing Postoperative Pain and Edema in Maxillofacial Traumatized Patients and Orthognathic Surgeries
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Scopus (15)
Crossref (11)
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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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Publication Date
Thu Sep 01 2022
Journal Name
Translational Research In Anatomy
Unusual large central sphenoethmoidal cell separating the two sphenoid sinuses - A case report
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Scopus (3)
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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Familial Pulmonary Alveolar Microlithiasis: A Rare Case Report with Emphasis on Imaging Findings
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ABSTRACT Pulmonary alveolar microlithiasis is rare infiltrative pulmonary disease characterized by intra-alveoli deposition of microliths. We present a familial case of an adult female with complaint of progressive shortness of breath on exertion. Chest radiograph showed innumerable tiny dense nodules, diffusely involving both lungs mainly the lower zones. High-resolution CT scan illustrated widespread intra-alveolar microliths, diffuse ground-glass attenuation areas and septal thickening predominantly in the basal regions. Chest radiograph is all that is needed for the diagnosis of this case but CT scan was done to demonstrate the extent and severity of this disease

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Publication Date
Tue Jun 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Soft Tissue Changes Following Orthodontic Treatment of Bimaxillary Protrusion (A Clinical and Photographical Study)
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Background: Bimaxillary protrusion is considered as one of the most important causes to seek the orthodontic treatment to get better esthetics. This study aimed to test the effect of orthodontic treatment in improvement the facial esthetics. Materials and Methods: Ten Iraqi Arab females having bimaxillary protrusion based on Class I malocclusions treated with fixed orthodontic appliance and extraction of the maxillary and mandibular 1st permanent premolars. Pre and post-treatment facial profile photographs were taken for each patients and the effect of treatment was tested in comparison with the pre-treatment photographs by using seven angular measurements. Results: After treatment, the upper and lower lip projections were decreased signifi

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Crossref
Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Effects of Sleeve Gastrectomy as a Bariatric Surgery on Weight of Dietary Induced Obese Rats.
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Background: Obesity is becoming the healthcare epidemic world wide.Obesity is associated with reduced life expectancy, increased morbidity and mortality, and greater healthcare costs.Bariatric surgery is the only effective treatment for morbid obesity and is gaining increasing popularity. There has been a steady rise in the numbers and types of bariatric operations done worldwide in recent years butnon of prove to be ideal .Animal studies and use of animal models are significant element in the evolution of medical knowledge and the use of animals as a model for bariatric surgery is of importance to study the mechanisms of these operationsa and also help to develop new technique in management of obesity.Objectives:Study of effects of slee

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
A Comparison of Sagittal Sections of Short T1inversion Recovery and T2 Weighted Fast Spin Echo Magnetic Resonance Sequences for Detection of Multiple Sclerosis Spinal Cord Lesions
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Background: Multiple sclerosis is a chronic autoimmune inflammatory demyelinating disease of the central nervous system of unknown etiology. Different techniques and magnetic resonance image sequences are widely used and compared to each other to improve the detection of multiple sclerosis lesions in the spinal cord. Objective: To evaluate the ability of MRI short tau inversion recovery sequences in improvementof multiple sclerosis spinal cord lesion detection when compared to T2 weighted image sequences. Type of the study: A retrospective study. Methods: this study conducted from 15thAugust 2013 to 30thJune 2014 at Baghdad teaching hospital. 22 clinically definite MS patients with clinical features suggestive of spinal cord involvement,

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of The Medicine Baghdad
Do low back pain changes correlate with sagittal lumbar alignment changes after total hip replacement arthroplasty?
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Abstract Background: The hip joint and lumbar spine are both anatomically and functionally closely related as had shown by many authors. So the abnormality in one area can affect the other e.g. hip joint osteoarthritis can cause lumbar sagittal malalignment and backache. Objectives: is to see if there is significant improvement in backache after total hip replacement? And which degree of backache improvement is associated with significant changes in lumbar lordosis? Methods and patients: a prospective open trial study was performed on 30 patients who had severe hip osteoarthritis and chronic low back pain. Total hip replacement was performed to all patients. Backache and lumbar lordosis were measured by visual analogue scale and Cobb’s a

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