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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
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
La femme fugitive dans ‘’A une passante’’ de Charles Baudelaire
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The main subject of this poem is a chance meeting between Baudelaire and unknown beautiful lady.  Her presence represents the far-fetched, magnificent beauty. This beauty forms an aspect of idealism that takes its real existence and disappears immediately.

 

This emotional poem deals with the continuous despair that dates back to the Romantic age where it was a key topic; the passing woman embodies destiny. All this comes from constant experience and mad love through the poet’s view to a woman paving the way toward the unknown. Baudelaire, however, noticed this unknown through a passer-by that reflected the real and magical image of this unk

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Formulating a strategy for the Northern Oil Company(Case Study)
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                  The research aims to present a proposed strategy for the North Oil Company, and the proposed strategy took into account the surrounding environmental conditions and adopted in its formulation on the basis and scientific steps that are comprehensive and realistic, as it covered the main activities of the company (production and exploration activities, refining and refining activities, export and transport of oil, research and development activity, financial activity, information technology, human resources) and the (David) model has been adopted in the environmental analysis of the factors that have been diagnosed according to a

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Publication Date
Wed Feb 29 2012
Journal Name
Al-khwarizmi Engineering Journal
A New Audio Steganography System Based on Auto-Key Generator
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Stenography is the art of hiding the very presence of communication by embedding secret message into innocuous looking cover document, such as digital image, videos, sound files, and other computer files that contain perceptually irrelevant or redundant information as covers or carriers to hide secret messages.

In this paper, a new Least Significant Bit (LSB) nonsequential embedding technique in wave audio files is introduced. To support the immunity of proposed hiding system, and in order to recover some weak aspect inherent with the pure implementation of stego-systems, some auxiliary processes were suggested and investigated including the use of hidden text jumping process and stream ciphering algorithm. Besides, the suggested

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Publication Date
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
A reliable numerical simulation technique for solving COVID-19 model
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Engineering
A Review on Expansive Soils Stabilized with Different Pozzolanic Materials
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Soils that cause effective damages to engineer structures (such as pavement and foundation) are called problematic or difficult soils (include collapsible soil, expansive soil, etc.). These damages occur due to poor or unfavorited engineering properties, such as low shear strength, high compressibility, high volume changes, etc. In the case of expansive soil, the problem of the shrink-swell phenomenon, when the soil reacts with water, is more pronounced. To overcome such problems, soils can be treated or stabilized with many stabilization ways (mechanical, chemical, etc.). Such ways can amend the unfavorited soil properties. In this review, the pozzolanic materials have been selected to be presented and discussed as chem

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Publication Date
Sat Sep 01 2007
Journal Name
Al-khwarizmi Engineering Journal
A Fully Computerized Method to Backup the Router Configuration File
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This paper presents a fully computerized method to backup the router configuration file. The method consists of a friendly graphical interface programmed by Java programming language.

    The proposed method is compared with the two existing methods, namely: TFTP server method and Copy/Paste method. The comparison reveals that the proposed method has many advantages over the existing ones. The proposed method has been implemented on Cisco routers (series 2500, 2600 and 2800).

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Strategic Entrepreneur ship and its role in a marketing performance
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The current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o

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Publication Date
Sun May 01 2022
Journal Name
Journal Of Engineering
The Collapsible Soil, Types, Mechanism, and identification: A Review Study
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Collapsible soil has a metastable structure that experiences a large reduction in volume or collapse when wetting. The characteristics of collapsible soil contribute to different problems for infrastructures constructed on its such as cracks and excessive settlement found in buildings, railways channels, bridges, and roads. This paper aims to provide an art review on collapse soil behavior all over the world, type of collapse soil, identification of collapse potential, and factors that affect collapsibility soil. As urban grow in several parts of the world, the collapsible soil will have more get to the water. As a result, there will be an increase in the number of wetting collapse problems, so it's very important to com

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Publication Date
Wed Oct 01 2008
Journal Name
2008 First International Conference On Distributed Framework And Applications
A strategy for Grid based t-way test data generation
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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
The Communicative Integration in New Media: Building a Communicative Model
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The internet, unlike other traditional means of communication, has a flexibility to stimulate the user and allows him to develop it. Perhaps, the reason for the superiority of the internet over other traditional means of communication is the possibility of change and transmission from one stage to another in a short period. This means that the internet is able to move from the use to the development of the use and then the development of means and innovation as the innovation of the internet is a logical product of the interaction of the user with the network. The internet invests all the proposals and ideas and does not ignore any even if it is simple. This is represented in social networking sites which in fact reflects personal emotio

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