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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 Oct 05 2019
Journal Name
Pediatric Cardiology
Personalised Warfarin Dosing in Children Post-cardiac Surgery
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Abstract<p>Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy a</p> ... Show More
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Publication Date
Fri Jan 11 2019
Journal Name
Brain Sciences
Sleep Disorders Following Mild and Moderate Traumatic Brain Injury
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(1) Background: Sleeping disorders are frequently reported following traumatic brain injury (TBI). Different forms of sleeping disorders have been reported, such as sleepiness, insomnia, changes in sleeping latency, and others. (2) Methods: A case-control study with 62 patients who were victims of mild or moderate TBI with previous admissions to Iraqi tertiary neurosurgical centers were enrolled as the first group, and 158 patients with no history of trauma were considered as the control. All were 18 years of age or older, and the severity of the trauma and sleep disorders was assessed. The Pittsburgh sleep quality index was used to assess sleep disorders with average need for sleep per day and average sleep latency were assessed in

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Acute Appendicitis and Multisystemic Inflammatory Syndrome due to COVID-19: a Case Report and Literature Review
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of Engineering
Energy, Exergy and Anergy Analysis of Vertical Split Air Conditioner Under experimental ON-OFF Cycling
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A time series analysis can help to observe the behavior of the system and specify the system faults. In addition, it also helps to explain the various energy flows in the system and further aid in reducing the thermodynamic losses. The intelligent supervisory LabVIEW software can monitor the incoming data from the system by using Arduino microcontroller and calculates the important parameters. Energy, exergy, and anergy analysis present in this paper to investigate the system performance as well as its components. To accomplish this, a 4-ton vertical split air conditioner based on vapor compression refrigeration cycle charged with refrigerant R-22 was modified for experimental analysis. The results showed that during 540

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Approach to Manage Congenital Absence of Anterior Cruciate Ligament in a 13 years old Patient – A Rare Case Report of Eastern India
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Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

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Publication Date
Fri Sep 26 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of bisphosphonate administration on teeth development and growth of the jaw bones in neonatal rats (histological and immunohistochemical study)
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Background: Bisphosphonates are potent inhibitors of osteoclastic bone resorption and widely used for the treatment of osteoporosis, and osteogenesis imperfecta in children. Clinical and experimental studies have demonstrated that Bisphosphonates delay or inhibit tooth eruption. This study tries to focus on the effect of bisphosphonate on teeth development and jaw bones growth. Materials and methods: The present study includes 65 neonatal rats during lactation period from 15 Albino Wister rats mother. Alendronate (one type of Bisphosphonates) was administrated orally (15 mg/kg) into 10 pregnant rats two times a week, while other 5 rats regard as control. Then the neonatal rats sacrificed in I, 6, 11, 16 and 21 days. The lower first molar we

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Bone Cutter Circumcision in Neonates
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Background: Bone cutter is widely used in the
Middle east area to cut the prepuce during circumcision.

Results :One hundred twenty one male neonates
were included in this study.The mean operative
time (MOT) was 6 minutes, mean time of
healing (MTH) was 5 days, 7 cases (5.9%)
developed early & late complications, 2 (1.7%)
had bleeding, 3 (2.5%) developed infection, 2
(1.7%) developed late complications in the form
of meatal stenosis.
Settings:Al-Yarmouk Teaching Hospital and a
private surgical clinic.
Aim of the study: To assess the safety of
circumcision using bone cutter.
Methods: Over 6 years period from Jan. 2000
till Dec. 2005, one hundred twenty one male
neonates were circumci

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Publication Date
Fri Jan 01 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Evaluation of Morphological (Macroscopic and Microscopic) Parameters of Placentas in Pregnancies Complicated by Preeclampsia, Diabetes and Preeclampsia and Diabetes.
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This study was done to compare the morphometric parameters of placentas in well controlled patients with preeclampsia, diabetes, and preeclampsia-diabetes with that of normal uncomplicated placentas. Patients & Methods: A total of Twenty four placentas were freshly collected. Six placentas for control group and eighteen placentas for complicated group (preeclamptic-diabetic and preeclamptic--diabetic subgroups). The placentas were grossly examined (shape, number of cotyledons, weight, and thickness). After suitable fixation, tissue processing and sectioning, the sections were stained by hematoxylin and eosin to study the general morphology and morphometry of the following parameters: number of terminal villi, number of syncytial knots, numb

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study
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Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study
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Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compa

... Show More
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Scopus (10)
Crossref (5)
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