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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 Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
An Analysis of the Efficacy of Platelet-Rich Plasma Injections on the Treatment of Internal Derangement of a temporomandibular Joint
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Background: A Temporomandibular joint (TMJ) internal derangement (TMJID) is a disruption within the internal aspects of the TMJ in which the disc is displaced from its normal functional relationship with the mandibular condyle, after which the articular portion of the temporal bone causes joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJID. A platelet-rich plasma (PRP) injection is a simple, less invasive surgical procedure for the treatment of internal derangement. The objective of this study was to evaluate the efficacy of PRP injections in decreasing or eliminating pain, clicking, and limitation of mouth opening in patients with TMJID after th

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Publication Date
Wed Aug 01 2018
Journal Name
Collegian
Behaviour change interventions to improve medication adherence in patients with cardiac disease: Protocol for a mixed methods study including a pilot randomised controlled trial
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Publication Date
Mon May 11 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Dental arches dimensions, forms and its association to facial types in a sample of Iraqi adults with skeletal and dental class II-division 1 and class III malocclusion(A cross sectional study)
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Background: The association between facial types and dental arches forms has considerable implications in orthodontic diagnosis and treatment planning. The aim was to establish the maxillary and mandibular dental arches width and length in skeletal and dental class II division 1 and class III malocclusion groups, find out the most frequent dental arch form and facial type and the association between them and to check the gender differences. Materials and Methods: Frontal and lateral facial photographs and maxillary and mandibular occlussal photographs for 90 iraqi subjects with age 18-25 years old (45 males and 45 females) divided equally into three groups, the 1st group with class II division 1malocclusion (overjet more than 3mm but less t

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Publication Date
Fri Dec 31 2021
Journal Name
Review Of International Geographical Education
Investing Organizational Identity in Improving Work Teams: An Exploratory Study of a Sample of The Capital's Traffic Directorates
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The research aims to identify the role of organizational identity in improving work teams, and to suggest ways to deal with the outputs of work teams in a way that achieves the goals of the Baghdad Traffic Directorate as it is the subject of the application of the research, while the research community was represented by its officers, while the research sample was embodied in (General Director, Associate The Director General, the directors of Rusafa and Karkh traffic and their assistants, as well as the heads of the divisions and the officials of the departments) in it. The sample was (200) observations. The descriptive exploratory approach was devoted to conducting the research, relying on the questionnaire in data collection, as well as e

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Publication Date
Mon May 11 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of tongue space area in a sample of Iraqi adults with class I dental and skeletal pattern
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Background: Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. This study aimed to determine the tongue and surrounding space area in a sample of Iraqi adults with class I dental and skeletal pattern. Materials and methods: The study included thirty healthy subjects (15 males and 15 females) with an age ranged between 23-34 years and class I dental and skeletal pattern with no history of any sleep related disorders. The assessed cephalometric measurement included length and height of the tongue and position of hyoid bone from cervical line. Descriptive statistics were obtained for the data. Genders difference was evaluated by independent sample t-test. Results: There wer

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Talent Management on Strategic Performance Reinforcement A field research on some of Sumer's university colleges.
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In this research we have tackled the role of Talent management (as a private variable) within (the Talent attraction, the Talent management performance, Talent development and Talent retention) on strategic performance reinforcement ( accredited variable) within its dimensions ( financial perspective, costumer perspective, internal operations perspective and learning and development perspective). The research conducted on sample of some college teachers from two of Sumer's colleges. The research problem represented by the broad organization's competition as well as universities; which led these colleges to investigate it's skillful human staff to meet it's strategic performance. 

To meet the aims of

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Publication Date
Sun Jul 01 2018
Journal Name
Comprehensive Psychiatry
Complexity analysis of spontaneous brain activity in mood disorders: A magnetoencephalography study of bipolar disorder and major depression
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Publication Date
Mon Dec 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Comparative Study of Pressure Losses and Hole Cleaning Efficiency of Water and Polymer solutions in Horizontal Wells
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The main objective of this study is to experimentally investigate the effect of the CMC polymeric drag reducer on the pressure drop occurred along the annulus of the wellbore in drilling operation and investigate the optimum polymer concentration that give the minimum pressure drop. A flow loop was designed for this purpose consist from 14 m long with transparent test section and differential pressure transmitter that allows to sense and measure the pressure losses along the test section. The results from the experimental work show that increasing in polymer concentration help to reduce the pressure drop in annulus and the optimum polymer concentration with the maximum drag reducing is 0.8 kg/m3. Also increasing in flow rate a

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Publication Date
Fri Jan 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
A Study of the Land Cover of Razzaza Lake during the Past 25 Years Using Remote Sensing Methods
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In this study, the Earth's surface was studied in Razzaza Lake for 25 years, using remote sensing methods. Images of the satellites Landsat 5 (TM) and 8 (OLI) were used to study and determine the components of the land cover. The study covered the years 1995-2021 with an interval of 5 years, as this region is uninhabited, so the change in the land cover is slow. The land cover was divided into three main classes and seven subclasses and classified using the maximum likelihood classifier with the help of training sets collected to represent the classes that made up the land cover. The changes detected in the land cover were studied by considering 1995 as a reference year. It was found that there was a significant reduction in the water mass

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Publication Date
Fri Mar 10 2023
Journal Name
Aspac J. Mol. Biol. Biotechnol
Influence of IL-28B serum level and gene polymorphism in a sample of Iraqi patients with ankylosing spondylitis
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Ankylosing spondylitis (AS) represents one kind of advanced arthritis formed via inflammatory stimuli long-term in the spin‘s joints. Interleukin (IL)-29 (interferon- lambda1(IFN- λ1)), interleukin (IL)-28A (interferon- lambda 2 (IFN- λ2)) and interleukin (IL)-28B (interferon- lambda 3(IFN-λ3)) are three interferon lambda (IFN- λs) molecules that have recently been identified as new members of the IFN family. IL-28B expression in ankylosing spondylitis (AS) is not well understood. 150 male healthy controls ((HC) and 160 males with AS as patients group participated in this study. Serum level and gene polymorphism were assessed using an enzyme-linked immunosorbent assay and Sanger sequencing for IL-28B, respectively. The results showed

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