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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 Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Wed Sep 01 2021
Journal Name
Acta Pharmaceutica Sinica B
Discovery of a potent and dual-selective bisubstrate inhibitor for protein arginine methyltransferase 4/5
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Publication Date
Fri Apr 01 2022
Journal Name
Heliyon
Stigma towards health care providers taking care of COVID-19 patients: A multi-country study
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Publication Date
Fri Sep 30 2011
Journal Name
Al-khwarizmi Engineering Journal
Steady State Performance Investigation of a Three Phase Induction Motor Running Off Unbalanced Supply Voltages
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The objective of this work is to investigate the performance of a conventional three phase induction motor supplied by unbalanced voltages. An effort to study the motor steady state performance under this disturbance is introduced. Using per phase equivalent circuit analysis with the concept of symmetrical components approach, the steady state performance is theoretically calculated. Also, a model for the induction motor with the MATLAB/Simulink SPS tools has been implemented and steady state results were obtained. Both results are compared and show good correlation as well. The simulation model is introduced to support and enhance electrical engineers with a complete understanding for the steady state performance of a fully loaded induc

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Low-carbon Technologies
Performance evaluation of the photovoltaic thermal system with a fin array and surface zigzag layout
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Abstract<p>Solar photovoltaic (PV) has many environmental benefits and it is considered to be a practical alternative to traditional energy generation. The electrical conversion efficiency of such systems is inherently limited due to the relatively high thermal resistance of the PV components. An approach for intensifying electrical and thermal production of air-type photovoltaic thermal (PVT) systems via applying a combination of fins and surface zigzags was proposed in this paper. This research study aims to apply three performance enhancers: case B, including internal fins; case C, back surface zigzags; and case D, combinations of fins and surface zigzags; whereas the baseline smooth duct rep</p> ... Show More
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Publication Date
Thu May 28 2020
Journal Name
Journal Of Generic Medicines: The Business Journal For The Generic Medicines Sector
Determinants of national drug products acceptance across patients, pharmacists, and manufacturers: A mixed method study
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Introduction

The national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions.

Methods

This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The stud

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Publication Date
Wed Aug 21 2019
Journal Name
Al-khwarizmi Engineering Journal
Design and Optimization of a Surface-Mounted Permanent-Magnet Linear Synchronous Motor with Maxwell ANSYS
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Linear motor offers several features in many applications that require linear motion. Nevertheless, the presence of cogging force can deteriorate the thrust of a permanent magnet linear motor. Using several methodologies, a design of synchronous single sided linear iron-core motor was proposed. According to exact formulas with surface-mounted magnets and concentrated winding specification, which are relying on geometrical parameters. Two-dimensional performance analysis of the designed model and its multi-objective optimization were accomplished as a method to reduce the motor cogging force using MAXWELL ANSYS. The optimum model design results showed that the maximum force ripple was approximatrly reduced by 81.24%compared to the origina

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Publication Date
Mon Feb 01 2021
Journal Name
Proceedings Of The Institution Of Civil Engineers - Structures And Buildings
Effect of soil saturation on load transfer in a pile excited by pure vertical vibration
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A comparison between the resistance capacity of a single pile excited by two opposite rotary machines embedded in dry and saturated sandy soil was considered experimentally. A small-scale physical model was manufactured to accomplish the experimental work in the laboratory. The physical model consists of: two small motors supplied with eccentric mass 0·012 kg and eccentric distance 20 mm representing the two opposite rotary machines, an aluminum shaft with 20 mm in diameter as the pile, and a steel plate with dimensions of (160 × 160 × 20 mm) as a pile cap. The experimental work was achieved taking the following parameters into consideration, pile embedment depth ratio (L/d; length to diameter) and operating freq

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Publication Date
Mon Jan 01 2018
Journal Name
Ndt &amp; E International
Porosity evaluation of in-service thermal barrier coated turbine blades using a microwave nondestructive technique
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