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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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Sun Jan 01 2017
Journal Name
International Journal Of Medical Research & Health Sciences
Clinical and Radiographical Assessment of Alveolar Bone Loss Associated with Overhang Amalgam Filling
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Thu Jan 01 2015
Journal Name
Basrah Journal Of Veterinary Research
Prenatal Histological study of the limbs bone onset development in Guinea pig (CaviaCutleri)
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Tue Mar 01 2022
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Iranian Journal Of War And Public Health
Histological Evaluation of Vitronectin Protein/AngiopoietinLike 4 Protein on Bone Healing in Rats
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2929-2933

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Possible Protective Effects of Lutein against Ciprofloxacin Induced Bone Marrow Toxicity in Rats
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Ciprofloxacin, which is a second generation of fluoroquinolone and one of the most effective and widely used drugs within fluoroquinolone. Unfamiliar adverse effects of ciprofloxacin such as bone marrow (BM) suppression, thrombocytopenia, anemia, agranulocytosis, renal failure, and others observed. Lutein, is a xanthophyll (an oxygenated carotenoid), was focused by most studies as it has a strong antioxidant activity in vitro; and also, it has been associated with reducing the risk of the age-related disorders. The current study was designed to describe the role of apoptosis through the measurement of Bcl-2 associated X protein (Bax) marker, as mechanisms of bone marrow toxicity induced by ciprofloxacin and to find whether lutei

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Craniofacial Surgery
Effect of Platelet-Rich Fibrin and Bone Morphogenetic Protein on Dental Implant Stability
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Abstract: Recombinant human bone morphogenetic protein-2 (rhBMP-2) and platelet-rich fibrin (PRF) bioactive materials have been used to enhance healing and improve dental implant stability. This study aimed to compare the effect of rhBMP-2 and PRF bioactive materials on dental implant stability at different intervals and to evaluate the correlation of implant length and diameter with implant stability. Two bioactive materials were compared to evaluate their effect on dental implant stability. A total of 32 patients (102 dental implants) were divided into 3 groups: 24 dental implants with bone morphogenetic protein (BMP), 27 dental implants with PRF, and 51 dental implants without BMP or PRF (control group). Data were statistically analyzed

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Publication Date
Sat Mar 03 2012
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International Urology And Nephrology
GFR estimation in the morbidly obese pre- and postbariatric surgery: one size does not fit all
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Multiple Intelligence Test Item Selection-Based on Howard Gardner's MI Model Using a Generalized Partial Estimation Model: Ministry of Education \ Karkh First Directorate of Education
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The aim of the research is to examine the multiple intelligence test item selection based on Howard Gardner's MI model using the Generalized Partial Estimation Form, generalized intelligence. The researcher adopted the scale of multiple intelligences by Kardner, it consists of (102) items with eight sub-scales. The sample consisted of (550) students from Baghdad universities, Technology University, al-Mustansiriyah university, and Iraqi University for the academic year (2019/2020). It was verified assumptions theory response to a single (one-dimensional, local autonomy, the curve of individual characteristics, speed factor and application), and analysis of the data according to specimen partial appreciation of the generalized, and limits

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Studying the Radial and Tangential Velocity Components of the Epithelization Healing Post Photorefractive Keratectomy Surgery of the Human Eye
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Photorefractive keratectomy (PRK) is the refractive technique that began with a physical scraping of the epithelial layer of cornea subsequent by laser treatment. Post this procedure to about 48 hours the removed epithelial layer regenerated to protect the eye again. The regeneration process (called re-epithelization) started from the limbus of the cornea toward the central part of it. The re-epithelization mechanism consists of a change in cell density (mitosis) and cell concentration (migration) with a velocity in two directions: radial and tangential. In the present study, an estimation for both radial (responsible for the overlapped layers toward the outward direction of the cornea) and tangential comp

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Publication Date
Tue Oct 01 2024
Journal Name
Journal Of Physics: Conference Series
The operational matrices for Elliptic Partial Differential Equations with mixed boundary conditions
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Abstract<p>The purpose of this research is to implement the orthogonal polynomials associated with operational matrices to get the approximate solutions for solving two-dimensional elliptic partial differential equations (E-PDEs) with mixed boundary conditions. The orthogonal polynomials are based on the Standard polynomial (<italic>x<sup>i</sup> </italic>), Legendre, Chebyshev, Bernoulli, Boubaker, and Genocchi polynomials. This study focuses on constructing quick and precise analytic approximations using a simple, elegant, and potent technique based on an orthogonal polynomial representation of the solution as a double power series. Consequently, a linear </p> ... Show More
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Publication Date
Mon Apr 01 2019
Journal Name
International Journal Of Research - Granthaalayah
CALCULATION OF THE STOPPING POWER OF ALPHA PARTICLES AND ITS RANGE IN BONE TISSU
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With the advancement of modern radiotherapy technology, radiation dose and dose distribution have significantly improved. as part of Natural development, interest has recently been renewed by treatment, especially in the use of heavy charged particles, because these radiation types serve theoretical advantages in all biological and physical aspects. The interactions of alpha particle with matter were studied and the stopping powers of alpha particle with Bone Tissue were calculated by using Zeigler’s formula and SRIM software, also the Range for this particle were calculated by using Mat lab language for (0.01-1000) MeV alpha energy.