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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
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic innovation components of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Post & Telecommunications
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Abstract:

        Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
The grammatical approach to explain Bant Souad's poem (Explanation of Ibn Hisham as a model) a . M . Dr. Abdul Hamid Hamad shehatha Mustansiriya University Faculty of Basic Education the department of Arabic language
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This study is concerned with shedding light on the grammatical method of Ibn Hisham Al-Ansari (761 AH), in his explanation of Bant Souad’s poem by the poet Kaab bin Zuhair, and I included a brief description of Ibn Hisham’s life with a number of explanations of this poem, then clarified the most important features of this method The grammar represented by his reliance on hearing and presenting it to analogy with mention of types of analogy, as well as his attribution of opinions to their owners with weighting, selection and balancing, and his attention to reasoning and a number of grammatical ailments, and his approach is also distinguished by following the method of fractal.

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of Biology, Agriculture And Healthcare
Histopathological Changes of Some Internal Organs of Mice Injected with Exotoxin a at Low Concentrations
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Abstract Exotoxin A is the most lethal virulence factor produced by Pseudomonas aeruginosa. It inhibits elongation factor-2 by ADP-ribosylation of EF2. This causes stop of the elongation of polypeptides. In recent study, the effect of low concentration of exotoxin A on some important internal organs of mice was studied. Four groups white mice were injected intraperitonialy with pure exotoxin A in the following manner 0.1, 0.2, 0.3, 0.4 ng\ animals. One mouse receives normal saline inrtaperitonialy as a control. After 72 hours the mice were killed and four organs were taken, liver, spleen, lung and heart from each killed mice. Histological sections were made from each organ and stained with hematoxylin and eosin stain then examined under mic

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Publication Date
Sat May 02 2015
Journal Name
التربية العلمية
the effect of a strategy on the reading compreheehension of first-yearinter intermediate school students
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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Use of Ascetic Fluid Cholesterol as a Marker to Differentiate between Types of Ascetic Fluid
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Background:- Cholesterol is high in ascetic fluid due
to malignancy and other causes of exudates.
Objective:-To use cholesterol as a marker to
differentiate between exudative and transudative
ascetic fluid and to compare that with other routine
parameters.
Methods:-Twenty eight patients were included in this
study 17 females with mean age of 41.9 years, 11
males with mean age of 48.2 years. The patients were
divided in group I suspected transudate, and group II
suspected exudate according to history and clinical
examination.
Ascetic fluid samples were sent for total protein,
albumin, and cholesterol measurement blood samples
were sent for serum protein and albumin measurement.
Results:-In this

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for the Development of Moral Intelligence among Preparatory Students
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This current research aims to identify the effectiveness of a training program in developing moral intelligence and mutual social confidence among middle school students. The researcher made a number of hypotheses for this purpose to achieve the goal of the research.                             

The researcher relied on the (Al Zawaida 2011) scale prepared according to Coles (1997), including (60) items, and the mutual social trust scale for (Nazmi 2001) based on Roter's theory including (38) items.               &nbsp

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Publication Date
Wed Jun 03 2015
Journal Name
Al-ustath
Witchcraft and Women’s Spaces; A cultural Materialism Study of John Updike’s The Witches of Eastwick
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Witch stories are part of American popular culture, and this culture is extremely influenced by a continuing reliance on its past. The modern obsession of Americans with witches, whether real or metaphorical, is related to politics especially when it came to issues of gender politics. This article exposes a modern image of the female character seen from a male author point of view. John Updike, influenced by the changes that happened to women within second wave of feminism, attempted to write The Witches of Eastwick (1984). Actually, he presented women who did have a sort of careers. His witches are professional active and dynamic. What do witches stand for in American Culture? Why did Updike choose to write

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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Current Researches On Social Sciences
An Examination of Discourse Investigation of Fallacies in Religious Texts: Islam as a Case Study
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BN RASHİD, 2023

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Publication Date
Wed May 02 2018
Journal Name
Chempluschem
The Oxidation of Peroxide by Disordered Metal Oxides: A Measurement of Thermodynamic Stability “By Proxy”
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It is often noted that disordered materials have different chemical properties to their more “ordered” cousins. Quantifying these effects in terms of thermodynamics is challenging in part because disordered materials can be difficult to characterize and are frequently relatively unstable. During the course of our experiments to understand the effects of disorder in catalysts for water oxidation we observed that many disordered manganese and cobalt oxide water oxidation catalysts directly oxidized peroxide in contrast to their more ordered analogues which catalyzed its disproportionation, that is, MnO2+2H+ +H2O2! Mn2+ +2H2O+O2(oxidation) versus H2O2!H2O+1=2 O2(disproportionation). By measuring the efficiency for one reaction over the oth

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Publication Date
Sat Jun 01 2024
Journal Name
Iraqi Journal Of Physics
A Study the Addition of Silver Dioxide on Some Optical Properties of Phosphate Bioactive Glass
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This study investigates the influence of silver oxide (Ag2O) concentration on the optical characteristics of phosphate bioactive glasses (PBGs). PBGs have emerged as promising alternatives to conventional silicate glasses in the medical field due to their excellent bioactivity and chemical resistance. Samples with varying Ag2O concentrations (0, 0.25, 0.5, and 0.75g) were sintered at 780°C for 2 hrs in an electric furnace. The samples were subjected to Fourier transfer infrared spectroscopy (FTIR), ultraviolet-visible (UV-Vis) spectroscopy, and photoluminescence (PL) tests to assess their functional groups and optical properties. By analyzing the FTIR spectrum of phosphate bioactive glass containing different amounts of Ag2O, it is

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