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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
Comparison of Partial Least Squares and Principal Components Methods by Simulation
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Abstract                                                                                              

The methods of the Principal Components and Partial Least Squares can be regard very important methods  in the regression analysis, whe

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Solvability of Some Types for Multi-fractional Integro-Partial Differential Equation
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In this article, the solvability of some proposal types of the multi-fractional integro-partial differential system has been discussed in details by using the concept of abstract Cauchy problem and certain semigroup operators and some necessary and sufficient conditions. 

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Publication Date
Fri Dec 01 2023
Journal Name
Methods And Objects Of Chemical Analysis
Partial Least Squares Method for the Multicomponent Analysis of Antibacterial Mixture
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This study's objective is to assess how well UV spectrophotometry can be used in conjunction with multivariate calibration based on partial least squares (PLS) regression for concurrent quantitative analysis of antibacterial mixture (Levofloxacin (LIV), Metronidazole (MET), Rifampicin (RIF) and Sulfamethoxazole (SUL)) in their artificial mixtures and pharmaceutical formulations. The experimental calibration and validation matrixes were created using 42 and 39 samples, respectively. The concentration range taken into account was 0-17 μg/mL for all components. The calibration standards' absorbance measurements were made between 210 and 350 nm, with intervals of 0.2 nm. The associated parameters were examined in order to develop the optimal c

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Publication Date
Sat Sep 30 2023
Journal Name
Romanian Journal Of Rheumatology
Association between genetic polymorphism in tumor necrosis factor-alpha gene and adverse effects of etanercept in rheumatoid arthritis patients
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Background. Gene polymorphisms affect etanercept’s pharmacokinetics, pharmacodynamics, and side effects. This effect is evidenced by the extensive genetic variation in the drug’s targets. Objectives. This study aims to find the association between different genotypes of the promoter region of the TNF-α gene at -308G/A(rs1800629), -857C/T(rs1799724), -863 C/A(rs1800630), -1031 T/C (rs1799964), -806 C/T (rs4248158) and -376 G/A (rs1800750) and the side effects of ETN that occurred to Iraqi RA patients. Method. The trial included patients with rheumatoid arthritis who had been using ETN for at least six months. The participants were from the Baghdad Teaching Hospital Rheumatology Unit. The PCR was sequenced to determine the polymo

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Publication Date
Thu May 10 2018
Journal Name
Global Journal Of Health Science; Issn 1916-9736 E-issn 1916-9744
Effects of Biological and Non Biological Agents (Disease Modifying Antirheumatic Drugs) on Bone Mineral Density in a Sample of Rheumatoid Arthritis Patients
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Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D

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Publication Date
Sun Sep 28 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of the Efficacy of Sinus Balloon Technique on Transcrestal Maxillary Sinus Floor Elevation Surgery
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Background: A minimally invasive antral membrane balloon elevation (MIAMBE) has been introduced to overcome the invasiveness of modified Caldwell-Luc (lateral approach) and the drawbacks of the osteotome (summers' technique) in maxillary sinus floor elevation surgery. Materials and methods: A total of 13 adult Iraqi patients aged 28-55 years, 4 males and 9 females underwent sinus floor elevation surgery via crestal approach by using sinus balloon technique. A panoramic radiograph and (Cone beam computed tomography (CBCT)/or medical CT scan) were obtained before and after surgery. Postoperative gained bone was assessed and the patient reactions including pain, nasal bleeding, and ecchymosis were recorded. The whole follow up period was 1yea

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Publication Date
Fri May 25 2018
Journal Name
Journal Of Physics: Conference Series
Partial purification of Leucine aminopeptidase (LAP) in Acromegalic Sample of Iraqi Patients
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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Effect of Partial Coherence illuminated bar on evaluation technique of diffraction image
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In this work, we are obviously interested in a general solution for the calculation of the image of a single bar in partially coherent illumination. The solution is based on the theory of Hopkins for the formation of images in optical instruments in which it was shown that for all practical cases, the illumination of the object may be considered as due to a self – luminous source placed at the exit pupil of the condenser , and the diffraction integral describing the intensity distribution in the image of a single bar – as an object with half – width (U0 = 8 ) and circular aperture geometry is viewed , which by suitable choice of the coherence parameters (S=0.25,1.0.4.0) can be fitted to the observed distribution in various types of mi

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Limit the auditor's personal judgment and its reflection on the quality of the audit report
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The main objective of the audit is The asset is maintained and operated efficiently and is done through to detect fraud and errors in the financial statements and to verify the accuracy and accuracy of the information contained therein and to give a neutral technical opinion on the basis of that, thus the auditor has a professional responsibility in achieving this goal, and that the effects of issuing a wrong opinion works on The loading of the beneficiaries is significant damage, And therefore the presence of any error or bias of the auditor when taking personal judgments in relation to the determination of the relative importance and the selection of audit samples and determine the adequacy and validity of evidence and implemen

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Publication Date
Sun Nov 02 2014
Journal Name
Autophagy
Autophagy in osteoblasts is involved in mineralization and bone homeostasis
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