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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
Wed May 10 2023
Journal Name
Dermatology Research And Practice
Interleukin-15 and Tumor Necrosis Factor-α in Iraqi Patients with Alopecia Areata
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Background. Alopecia areata (AA) is a common form of noncicatricial hair loss of unknown cause, affecting 0.1-0.2% of the general population. Most evidence supports the hypothesis that it is disease of the hair follicle of autoimmune nature mediated by T-cells, with important cytokine role. Objective of the Study. The objective of this study is to study the association and changes in serum levels of interleukin-15 (IL-15) and tumor necrosis factor-α (TNF-α) in patients with AA in relation to the type, activity, and disease duration. Patients and Methods. Thirty-eight patients with AA and 22 individuals without the disease as controls were enrolled in this case-controlled study conducted in the Department of Dermatology in the Al-K

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Publication Date
Tue Oct 04 2022
Journal Name
International Journal Of Dentistry
Comparison between Rolled and Nonrolled U-Shaped Flap in the Second Stage of Dental Implant Surgery: A Randomized Clinical Trial
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Background. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh

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Publication Date
Wed Apr 05 2023
Journal Name
International Journal Of Interactive Mobile Technologies (ijim)
A Partial Face Encryption in Real World Experiences Based on Features Extraction from Edge Detection
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User confidentiality protection is concerning a topic in control and monitoring spaces. In image, user's faces security in concerning with compound information, abused situations, participation on global transmission media and real-world experiences are extremely significant. For minifying the counting needs for vast size of image info and for minifying the size of time needful for the image to be address computationally. consequently, partial encryption user-face is picked. This study focuses on a large technique that is designed to encrypt the user's face slightly. Primarily, dlib is utilizing for user-face detection. Susan is one of the top edge detectors with valuable localization characteristics marked edges, is used to extract

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Publication Date
Thu Feb 01 2018
Journal Name
Iosr Journal Of Dental And Medical Sciences (iosr-jdms)
Inhibitory Effects of Nickel Chloride on Bone Composition
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Abstract: To study the effect of nickel chloride on bone composition of mice, a number of biophysical and biochemical parameters have been made use. The animals were divided into control and experimental and further subdivided into three groups I, II and III according to the dose of nickel chloride (NiCl2) administered to them i.e. 5.8, 12.8 and 28.2 mg/kg body weight, respectively. Femur bones were obtained by sacrificing the animals three weeks after weaning them once a week. The percentage loss between the wet weight and dry weight of femur in control animals was found to be 32.5+1.5 .In the three experimental groups I,II and III, the percentage loss was 30.4+1.4, 35.3+2.3 and 38.9+2.2 respectively. The percentage loss between the wet we

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Publication Date
Mon Jan 01 2024
Journal Name
Revista Española De Cirugía Oral Y Maxilofacial
The correlation of alveolar trabecular bone microstructure with bone density measured by cone-beam computed tomography (CBCT) and implant stability
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Preoperative Psycho-educational Program on Stress of Cardiac Surgery Patients
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Objective: The study aimed to determine the effectiveness of preoperative psycho - education al
program on cardiac surgery patients information and their level of stress. And find out the differences
in the Psycho educational
program with regard to patients demographic characteristics such as age and gender.
Methodology Aquazi-experimental study was carried out to determine the effectiveness of
preoperative education program on stress for cardiac surgery patients in Baghdad city from the 28th of
March, 2010 , to 19th of September ,2011.
The preoperative psycho - educational program, as well as the questionnaire was constructed as a tool of
data collection for the purpose of the study. Purposive (non probability) s

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Publication Date
Sat Mar 22 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Snare-Assisted Retrieval of an Embolized Broken Double Lumen from the Heart of a Female Patient Diagnosed with End Stage Kidney Disease: A Case Report
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Foreign body embolization is a rare but serious iatrogenic complication that might necessitate transcatheter or even surgical retrieval. A broken double-lumen catheter was snared using a goose neck snare kit. The procedure was successful, and the patient experienced no further complications.

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to comp

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Publication Date
Wed Feb 07 2018
Journal Name
Proceedings Of The 2018 4th International Conference On Mechatronics And Robotics Engineering
Secure Transition for Robotic Surgery With Elliptic Curve Diffie Hellman
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