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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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Sun Mar 01 2015
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Terrestrial Invertebrates as a Bioindicators of Heavy Metals Pollution
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Bioaccumulation of heavy metals in the terrestrial invertebrates in Al-Jadriyia district Baghdad- Iraq were investigated. Forth terrestrial invertebrates snails, slug, isopods, and diplopods , were selected for this study. The results showed that all invertebrate groups have the ability in accumulate considerable amounts of heavy metals. Higher levels of zinc and copper were observed in the isopods specimens, it's about ( 60.50±0.58 ) and ( 96.00±0.58 ) ppm respectively , while higher levels of lead were observed in the diplopods specimens ,it's about ( 23.00±1.15 ) ppm ,but the higher levels of both iron and cadmium were observed in snail specimens , it's about ( 590.00±1.15 ) and ( 9.50±1.15 ) ppm respectively .but the

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Publication Date
Wed Aug 26 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE ROLE OF A PROTEAN CAREER IN HIGH PERFORMANCE
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Thu Sep 10 2020
Journal Name
Journal Of Advances In Mathematics
A Study of The Density Property in Module Theory
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In this paper, there are two main objectives. The first objective is to study the relationship between the density property and some modules in detail, for instance; semisimple and divisible modules. The Addition complement has a good relationship with the density property of the modules as this importance is highlighted by any submodule N of M has an addition complement with Rad(M)=0. The second objective is to clarify the relationship between the density property and the essential submodules with some examples. As an example of this relationship, we studied the torsion-free module and its relationship with the essential submodules in module M.

Publication Date
Sat Sep 21 2019
Journal Name
Journal Of The College Of Education For Women
Zanjan , Name and Origin: A Glimpse of Its History
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The aim of study is to shed light on an Islamic city which is unknown for a lot of people, it can have an old history in Parisian country and many events happen with it , This city is characterized with political, military, economic scientific ,and social features, This city is called Zanjan and it is one of the most important cities because it dates back to the period of post history and it has a good geographic location whereas it was, passage for trade caravans to pass through as well its land which was specialized in agriculture and industry. the study follows chronological order of historical events for the city, one of the most significant conclusions is to think that this city does belong to artifacts and it is an old city and it

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
A RAISIN IN THE SUN: the dream of RECOGNITION
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Lorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination. 

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Publication Date
Tue Mar 01 2022
Journal Name
Bulletin Of The Australian Mathematical Society
A DYNAMICAL STUDY OF SALINE PLUMES IN DESALINATION OUTFALLS
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Fri Feb 02 2024
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A Linguistic Study of Metaphorical Expressions in Political Interviews
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In recent years, the linguo-philosophical studies of metaphor have tended to define metaphor as an interaction of the object, that is the referent of conceptualization and some features that are associated with sensual manner realities, whose name is used when resolving the conceptual problem-nominative situation, namely the situation of the formation of a new concept and its verbalization. The objective of this term paper lies in the phenomenon of metaphors used in modern political discourse. In our understanding a metaphor is not only of a linguistic nature, but also political. This paper approaches the subject of conceptual metaphor and political argumentation through the prism of synergies of the political topic, affirmative or negative

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Sun Dec 01 2013
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Yemeni political system: a study of the internal variables
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