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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 Jan 01 2016
Journal Name
Arpn Journal Of Engineering And Applied Sciences
Implementation And Evaluation Of Apm 2.6 - Controlled Quadcopter With Aerial Imagery As A Case Study
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Scopus (1)
Scopus
Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
Performance Evaluation of a Triple Concentric Tube Heat Exchanger Using Deionized Water and Oil-40
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This study examines experimentally the performance of a horizontal triple concentric tube heat exchanger TCTHE made of copper metal using water as cooling fluid and oil-40 as hot fluid. Hot fluid enters the inner annular tube of the TCTHE in a direction at a temperature of 50, 60 and 70 oC and a flow rate of 20 l/hr. On the other hand, the cooling fluid enters the inner tube and the outer annular tube in the reverse direction (counter current flow) at a temperature of 25 oC and flow rates of 10, 15, 20, 25, 30 and 35 l/hr. The TCTHE is composed of three copper tubes with outer diameters of 34.925 mm, 22.25 mm, and 9.525 mm, and thicknesses of 1.27 mm, 1.143 mm, and 0.762 mm, respectively. TCTHE tube's length was 670

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The functional diversity of the directorial vision in the political theater cinema as a model
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It is very necessary for the political theater to be within the space of every theatrical performance, so that the theater carries the diverse and enlightened values and cultures of this world. political theatre. In the first chapter, the researcher dealt with (the methodological framework), which includes the research problem identified by the researcher with the following question (the functional diversity of the directorial vision in the political theater)
Importance, purpose, limits and seal by defining terminology.
In the second chapter, the researcher dealt with the theoretical framework on two topics, the first (transformations of directorial vision in theatrical performance) and the second topic (aesthetic experiences i

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Crossref
Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
American strategic performance towards Middle East in the era of president Trump - A future study
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Abstract The strategic performance of the United States depends on dealing with the Middle East countries and its variants on several bases and motives that enabled them to achieve American hegemony and invest its interests at the expense of the region countries. Within this performance, the administration of the United State President Donald Trump presented the Strategic Document on December 18, 2017, which focused on the principle of "America First", to determine the direction of future US strategic performance in the formulation of means of cooperation and intersections or hostility in addition to interests and threats.The future vision of the Arab region and the Middle East as a whole, this strategy is based on the fact that

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Crossref
Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Design and Development of Smart List: A Mobile App for Creating and Managing Grocery Lists
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Research in consumer science has proven that grocery shopping is a complex and distressing process. Further, the task of generating the grocery lists for the grocery shopping is always undervalued as the effort and time took to create and manage the grocery lists are unseen and unrecognized. Even though grocery lists represent consumers’ purchase intention, research pertaining the grocery lists does not get much attention from researchers; therefore, limited studies about the topic are found in the literature. Hence, this study aims at bridging the gap by designing and developing a mobile app (application) for creating and managing grocery lists using modern smartphones. Smartphones are pervasive and become a necessity for everyone tod

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
An update on Nanoparticle Formulation Design of Piperine to Improve its Oral bioavailability: A Review
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Piperine, a crystalline alkaloid compound isolated from Piper nigrum, piper longum, and other types of piper, has had many fabulous pharmacological advantages for preventing and treating some specific diseases, such as analgesic, anti-inflammatory, hepatoprotective, antimetastatic, antithyroid, immunomodulatory, antitumor, rheumatoid arthritis, osteoarthritis, Alzheimer's, and improving the bioavailability of other drugs. However, its potential for clinical use through oral usage is hindered by water solubility and poor bioavailability. The low level of oral bioavailability is caused by low solubility in water and is photosensitive, susceptible to isomerization by UV light, which causes piperine concentration to decrease. Many different

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Scopus (8)
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Scopus Crossref
Publication Date
Mon Oct 01 2018
Journal Name
Arpn Journal Of Engineering And Applied Sciences
Achieving a theoretical approximation characterize the stopping power of heavy ion in D-T plasma
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The dependence of the energy losses or the stopping power for the ion contribution in D- T hot plasma fuels upon the corresponding energies and the related penetrating factorare arrive by using by a theoretical approximation models. In this work we reach a compatible agreement between our results and the corresponding experimental results.

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Scopus
Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
A Comparative Study on the Electrical Characteristics of Generating Plasma by Using Different Target Sources
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In this research, the electrical characteristics of glow discharge plasma were studied. Glow discharge plasma generated in a home-made DC magnetron sputtering system, and a DC-power supply of high voltage as input to the discharge electrodes were both utilized. The distance between two electrodes is 4cm. The gas used to produce plasma is argon gas which flows inside the chamber at a rate of 40 sccm. The influence of work function for different target materials (gold, copper, and silver), - 5cm in diameter and around 1mm thickness - different working pressures, and different applied voltages on electrical characteristics (discharge current, discharge potential, and Paschen’s curve) were studied. The results showed that the discharge cur

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Publication Date
Mon Jun 01 2015
Journal Name
Conference: 8th International Conference And Exhibition On Design And Production Of Machines And Dies/molds
Design, Construction, and Controlling of A Shaped Metal Deposition Machine Using Arc Metal-Wire System
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Publication Date
Sat Aug 12 2023
Journal Name
Southern African Linguistics And Applied Language Studies
Linguistic Deviations in Joseph Conrad's 'Heart of Darkness': A Pragmatic Perspective
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APDBN Rashid, Southern African Linguistics and Applied Language Studies, 2023

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