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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 Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-

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Publication Date
Thu Nov 01 2012
Journal Name
Journal Of Computer Science
VOICE ACTIVATION VISUALIZATION FOR ECHOCARDIOGRAPH AND 3D ANGIOGRAPHIC IMAGES IN SURGERY
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In some cases, surgeons need to navigate through the computer system for reconfirmation patients’ details and unfortunately surgeons unable to manage both computer system and operation at the same time. In this paper we propose a solution for this problem especially designed for heart surgeon, by introducing voice activation system with 3D visualization of Angiographic images, 2D visualization of Echocardiography processed video and selected patient’s details. In this study, the processing, approximation of the 3D angiography and the visualization of the 2D echocardiography video with voice recognition control are the most challenging work. The work involve with predicting 3D coronary three from 2D angiography image and also image enhan

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Publication Date
Tue Nov 29 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A proposed form for the Combined Assurance report and its impact In achieving sustainable development in the Iraqi economic units
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Despite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance  providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es

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Publication Date
Tue May 30 2023
Journal Name
Gsc Biological And Pharmaceutical Sciences
Anatomical study of the 3rd metacarpal bone of some mammals
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The current study included the anatomical structure of the metatarsal bone in sheep in terms of the traditional structural description of the bone, as it was found that the metatarsal bone in the fore and hind limbs of adult sheep had no visible differences between it and animals, especially ruminants. The metacarpal \tarsal bone No. 3 was cylindrical in shape, with the presence of the metacarpal \tarsal bones 2 and 4 declines, articulated from the proximal end with the metacarpal and metatarsal bones whereas from the distal part with the fetlock joint and the first phalanx bone. The aim of the study is to determine whether the environment and its changes in Iraq have affected the animals and their bones in terms of length, thicknes

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Publication Date
Tue Feb 01 2022
Journal Name
Baghdad Science Journal
Milk Tumor Necrosis Factor Alpha and Interleukin-1Beta Among Toxoplasma gondii-Free and Infected Women
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Pro-inflammatory cytokines play an important role in intercellular communications. In the last two decades, many cytokines have been identified in human milk. These cytokines are variable according to different conditions such as pathogenic infections which strongly stimulated the immune response. The present study aims to determine of IL1β and TNF-α in Toxoplasma gondii-free and infected women in an attempt to clarify the impacts of the infections on cytokines especially in mother's milk. The serum and milk sample were collected from 96 samples (48 for seropositive and 48 for seronegative). To confirm the Toxoplasma gondii infection; enzyme linked immunofluorescence assay (ELIFA) was used to detect anti-Toxoplasma Ig

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Publication Date
Sat Sep 27 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The role of topical application of bone morphogenetic protein 7 (BMP7) on bone healing on rabbits (Immunohistochemical study on TGF-β 3 & IGF-1R)
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Background: Bone is essentially a highly vascular, living, constantly changing mineralized connective tissue. It is remarkable for its hardness, resilience and regenerative capacity, as well as its characteristic growth mechanisms. This study aimed to: 1. To evaluate the effect of bone morphogenetic protein7 (BMP7) on bone healing in artificially created intrabony defect in rabbits upper diastema, histologically. 2. To study the immunohistochemical expression of TGF-β3 and IGF-1R as bone formation markers in experimental and control groups during bone healing. Material and method: Forty male rabbits, was used in this study, 8 rabbits for each healing interval (3 days, 1,2 ,4 and 6 weeks). In each rabbit two bone holes were created on th

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Publication Date
Wed Apr 14 2021
Journal Name
Wireless Personal Communications
A Partial CSI Estimation Approach for Downlink FDD massive-MIMO System with Different Base Transceiver Station Topologies
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Massive multiple-input multiple-output (massive-MIMO) is a promising technology for next generation wireless communications systems due to its capability to increase the data rate and meet the enormous ongoing data traffic explosion. However, in non-reciprocal channels, such as those encountered in frequency division duplex (FDD) systems, channel state information (CSI) estimation using downlink (DL) training sequence is to date very challenging issue, especially when the channel exhibits a shorter coherence time. In particular, the availability of sufficiently accurate CSI at the base transceiver station (BTS) allows an efficient precoding design in the DL transmission to be achieved, and thus, reliable communication systems can be obtaine

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Publication Date
Mon May 06 2024
Journal Name
Journal Of Pakistan Association Of Dermatologists
Assessment of tumor necrosis factor alpha and interleukinـ10 in obese psoriatic patients before and after using apremilast
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Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders.   Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients.   Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
Thyroid Hemiagenesis with Ipsilateral Parathyroid Adenoma; Case report with Review of the Literature
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Thyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.

Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because

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