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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
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
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The research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac

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Publication Date
Fri Oct 07 2022
Journal Name
Texas Journal Of Engineering And Technology
Estimation of Pore Pressure and In-Situ Stresses for Halfaya Oil Field: A Case Study
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Publication Date
Sun Dec 01 2013
Journal Name
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Methods for simultaneous detection of the cyanotoxins BMAA, DABA, and anatoxin-a in environmental samples
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Publication Date
Wed Mar 25 2026
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Numerical Analysis of Double Diffusive Laminar Natural Convection in a Right Angle Triangular Solar Collector
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The evaluation a proposed strategy for the Ministry of Planning for the years 2018-2022 .
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abstract

the research discussed a stage of strategic management. The strategic of the evaluation of the proposed strategy through feedback is to ensure that it is implemented with the least possible variation. The research aims at evaluation  a proposed strategy for the Ministry of Planning for the years 2018-2022 in line with the orientations of the state, taking into account the surrounding environmental conditions. It relies on scientific bases and steps to formulate the strategy The extent of the strategy suitability was tested through a set of statistical means and its objectivity was verified through a survey of a number of specialized experts who were selected in accordance with the principle

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Publication Date
Sun Sep 01 2019
Journal Name
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Common Fixed Point of a Finite-step Iteration Algorithm Under Total Asymptotically Quasi-nonexpansive Maps
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      Throughout this paper, a generic iteration algorithm for a finite family of total asymptotically quasi-nonexpansive maps in uniformly convex Banach space is suggested. As well as weak / strong convergence theorems of this algorithm to a common fixed point are established. Finally, illustrative numerical example by using Matlab is presented.

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Publication Date
Thu Jun 12 2025
Journal Name
Al-adab Journal
Deconstructing the Archetypal Mirror of Godot in Ali Abdul-Nabi Al-Zaidi’s “A Second Death”
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لطالما كان انتظار الملأ للخلاص والتي ترتبط بشكل اساسي بال "منتظر" او ال "مخلص" جزءا من الوعي الجمعي الذي تطور ليكون مرتبطا بالنمط البدائي والذي بدوره أصبح مرآةً تنعكس على اساسها فرص الانسان نحو النجاة. في مسرح القرن العشرين, لم تنفك فكرة الانتظار ان ترتبط بمسرحية صاموئيل بيكيت العبثية " في انتظار غودو" كونها مثالا رمزيا بالرغم من انه تجسيد شخصية "غودو" وقعت تحت وطأة الكثير من عمليات التحوير والتغيير في اطاره

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Publication Date
Fri Oct 28 2022
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Applications of contemporary feminist theory and its role in international relations (Singapore as a Model)
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Since the emergence of the science of international relations as an independent academic scientific field,  various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories,  which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination

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Publication Date
Fri Aug 02 2019
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The Fifth Conference On Smart Monitoring, Assessment And Rehabilitation Of Civil Structures Smar 2019
Rehabilitation of Mohammed Al-Qassim Bridge after Fire Attack Using CFRP Sheets: A Case Study
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Publication Date
Thu May 23 2019
Journal Name
The International Journal Of Artificial Organs
Real-time classification of shoulder girdle motions for multifunctional prosthetic hand control: A preliminary study
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In every country in the world, there are a number of amputees who have been exposed to some accidents that led to the loss of their upper limbs. The aim of this study is to suggest a system for real-time classification of five classes of shoulder girdle motions for high-level upper limb amputees using a pattern recognition system. In the suggested system, the wavelet transform was utilized for feature extraction, and the extreme learning machine was used as a classifier. The system was tested on four intact-limbed subjects and one amputee, with eight channels involving five electromyography channels and three-axis accelerometer sensor. The study shows that the suggested pattern recognition system has the ability to classify the sho

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