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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
Sun Sep 28 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Validity of Hounsfield Units from computed tomographic images of mandibular bone in detection of osteoporosis
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Background: The figure for the clinical application of computed tomography have been increased significantly in oral and maxillofacial field that supply the dentists with sufficient data enables them to play a main role in screening osteoporosis, therefore Hounsfield units of mandibular computed tomography view used as a main indicator to predict general skeleton osteoporosis and fracture risk factor. Material and Methods: Thirty subjects (7 males &23 females) with a mean age of (60.1) years underwent computed tomographic scanning for different diagnostic assessment in head and neck region. The mandibular bone quality of them were determined through Hounsfield units of CT scan images and were correlated with the bone mineral density v

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Publication Date
Thu Mar 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Topical Application of Flavanoids Extract of Hibiscus Sabdariffa on Experimentally Induced Bone Defect
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Background: The restoration of bone continuity and bone union are complex processes, and their success is determined by the effectiveness of osteosynthesis. The use of plants for healing purposes predates human history and forms the source of current modern medicine The aim of this study: It was histological evaluation of effect of topical application of flavonoid on healing of induced bone defect in rabbit tibia. Material and method: Twenty-four Adult New Zealand rabbits used in this study, they were divided into four groups for the healing periods (3days, 1,2, and 4weeks) Two holes were induced in rabbit tibia one on the left side and has been left to heal normally as control. While, the other hole made on the right side filled with flavo

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Crossref (4)
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Publication Date
Sat Mar 03 2012
Journal Name
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
Mon Jan 02 2012
Journal Name
Karbala Journal Of Medicine
Open Tibial Shaft Fractures Treated By Primary External Fixation And Bone Graft
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Eprospective study undertaken between January 2007 and January 2011, 58 consecutive cases with compound tibial shaft fractures. All fractures were stabilized by external fixator device AO/ASIF type after failed the manipulation under anesthesia (MUA) to restore the osseous alignment. In 32 patients cancellous bone graft were used from the upper part of the tibia to enhance healing process, all these patients were followed for an average of 8–12 months. Our findings showed that stabilization of the fracture shaft tibia by external fixation with cancellous bone graft had significantly better result, than external fixation alone. We conclude that unilateral, uniplanar external fixation with early bone grafting from upper part of the tibia is

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Publication Date
Tue Aug 23 2022
Journal Name
International Journal Of Health Sciences
Association between periostin and bone minerals in osteoporosis and osteopenia Iraqi patients
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Background: osteoporosis is characterized by a reduction in bone mineral density, skeletal microstructure breakdown, increased bone fragility, and fracture susceptibility. Osteopenia is the preceding step to osteoporosis because it causes a decrease in bone mass, osteoporosis reduces a person's quality of life. Periostin (encoded by Postn), its name is derived from the fact that it was first detected in periosteal osteocytes and osteoblasts. Periostin deficiency has been linked to osteoporosis and weak bones. Study objectives: The purpose of this study was to determine periostin levels in serum of Iraqi patients with osteoporosis and osteopenia, and it is also possible to consider periostin as a diagnostic factor to follow the progression o

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Publication Date
Mon Apr 17 2023
Journal Name
International Journal Of Veterinary Science And Medicine
Donor variability of ovine bone marrow derived mesenchymal stem cell - implications for cell therapy
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Crossref (6)
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Publication Date
Sun Sep 28 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of bone density after six months from dental implants placement using Computed Tomography
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Background: Determination of local bone mineral density (BMD) immediately after implant insertion play an important role in implant success rate, may offer comprehensive description of the bone, and give enough information to the surgeon prior to implant insertion and at follow up status. The aim of the present study is to evaluate the changes of local bone density in the dental implant recipient sites by using computerized tomography. Material and method: The sample consisted of (20) dental implants recipient sites, bone density assessment was done twice, immediately after implants insertion and after six months. Results: The mean HU of the bone around the implant insertion site, immediately after implant placement was 552.28 HU, and inc

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Scaphoid Fracture Non Union Treated by Bone Graft and Plaster of Paris Cast Splint.
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Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).
Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.
Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Evaluation of Serum Osteocalcin and Osteopontin Levels as Bone Biochemical Markers in Postmenopausal Women.
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Background: Studies discussing the correlation between biochemical markers of bone turnover and the diagnosis of osteoporosis in postmenopausal Iraqi women are rare. This study is devoted to find out the significance of serum osteocalcin (OC) and osteopontin (OPN) levels with the incidence of osteoporosis and its major complication (fracture).Objectives: to investigate the significance of bone turnover biochemical markers; serum osteocalcin and serum osteopontin in evaluating osteoporosis for postmenopausal Iraqi women with and without history of vertebral fracture, as well as to explore the relationship of these markers with bone mineral density (BMD).Methods: Fifty seven postmenopausal women whose ages are fifty years old and over, cat

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Publication Date
Sun Jun 03 2012
Journal Name
Al-kindy College Medical Journal
Scaphoid Fracture Non Union Treated by Bone Graft and Plaster of Paris Cast Splint.
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Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ). Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months. Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end of 3rd mo

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