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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 Jun 06 2021
Journal Name
Engineering, Technology & Applied Science Research
Evaluation of the Variation in Dynamic Load Factor Throughout a Highly Skewed Steel I-Girder Bridge
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The Dynamic Load Factor (DLF) is defined as the ratio between the maximum dynamic and static responses in terms of stress, strain, deflection, reaction, etc. DLF adopted by different design codes is based on parameters such as bridge span length, traffic load models, and bridge natural frequency. During the last decades, a lot of researches have been made to study the DLF of simply supported bridges due to vehicle loading. On the other hand, fewer works have been reported on continuous bridges especially with skew supports. This paper focuses on the investigation of the DLF for a highly skewed steel I-girder bridge, namely the US13 Bridge in Delaware State, USA. Field testing under various load passes of a weighed load vehicle was u

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Publication Date
Tue Dec 01 2020
Journal Name
Cureus
Clinical Descriptive Study of Masturbatory Behavior Among Infants and Preschool Children: A Recent Observation From Iraq
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Publication Date
Sat Apr 02 2022
Journal Name
Neuroquantology
The Role of Neudesin as a Novel Biomarker – in Iraqi Patients with Parkinson's Disease and Osteoporosis
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Neuron-derived neurotrophic factor [NENF], a human plasma neurotrophic factor, also increases neurotrophic activity in conjunction with Parkinson's disease-related proteins in Neudesin. Although Neudesin (neuron-derived neurotrophic secreted protein) is a member of the membrane-associated progesterone receptor (MAPR) protein subclass, it is not evolutionary related to the other members of the same family. The expression of Neudesin is found in both brain and spinal cord from embryonic stages to adulthood, as w Neudesin levels in Parkinson's patients with osteoporosis disease and Parkinson's patients without osteoporosis disease, as well as the relationship between Neudesin levels, Anthropometric and Clinical Features (Age, Gender, BMI) and

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Crossref
Publication Date
Thu May 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Fracture strength of laminate veneers using different restorative materials and techniques (A comparative in vitro stuy)
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Background: Esthetic correction represents one of the clinical conditions that required the use of laminate veneers in premolars region. Aim of the study: The purpose of this study was to evaluate the fracture strength of the laminate veneers in maxillary first premolars, fabricated from either composite (direct and indirect techniques) or ceramic CAD/CAM blocks. Materials and Methods: Fifty sound human maxillary premolar teeth were used in this in vitro study. Teeth were divided randomly into one control group and four experimental groups of ten teeth each; Group A: Restored with direct composite veneer (Filtek Z250 XT), Group B: Restored with indirect composite veneers (Filtek Z250 XT), Group C: Restored with lithium disilicate ceramic CA

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Determination of paracetemol in pharmaceutical preparations samples by spectrophotometer using meta phenylenediamine as a chromogenic agent
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Publication Date
Mon Mar 15 2021
Journal Name
Al-adab Journal
A Socio-Pragmatic Analysis of Responses to Impoliteness in some Selected English and Arabic Literary Texts
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Crossref
Publication Date
Wed Jun 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
A proposed model for disclosing the role of the collective intelligence system in improving joint auditing
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This research aims to present a proposed model for disclosure and documentation when performing the audit according to the joint audit method by using the questions and principles of the collective intelligence system, which leads to improving and enhancing the efficiency of the joint audit, and thus enhancing the confidence of the parties concerned in the outputs of the audit process. As the research problem can be formulated through the following question: “Does the proposed model for disclosure of the role of the collective intelligence system contribute to improving joint auditing?”   

The proposed model is designed for the disclosure of joint auditing and the role

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Crossref
Publication Date
Thu May 14 2026
Journal Name
Al–bahith Al–a'alami
HUMAN MODELING IN THE IRAQI PRESS: (A Survey of Human Modeling for March And April 2011)
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This research deals with what so called concept of The Human Model and how Iraqi Media concerns of this concept practically as it plays a key role in attracting readers, on the first hand. On the second, it is important to shed light on the scientific desire of the Iraqi Media and how it deals with this contemporary trend especially in editorial media.

The importance of the research stems from the fact that it alerts to a new stream of modern trends in journalistic writing, according to many modern Arab and foreign media studies; and to the importance of employing human modeling in dealing with facts, events, issues and problems in various editorial arts within their effective influence in concilia

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Crossref
Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
(The role of the Security Council in Managing international crises (The Libyan crisis as a model
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The Security Council has an active role in addressing international crises and dealing with their causes. The Libyan crisis is one of the most important real tests of the Security Council and its role in maintaining international peace and security, as the Council has proven so far an ineffective role in resolving the crisis and dealing withtheir causes, which has prolonged its duration and increased its complexities and dangerous repercussions, perhaps the most prominent of which is the threat of the recently achieved cease-fire and the formation of a new transitional government led by Abdel Hamid al-Dabaiba, the growing significant obstacles facing the political process, foremost of which is the continued presence of foreign forces , m

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Crossref
Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The newspaper is a field for the use of phraseologism: Газета как сфера использованиея фразеологических единиц
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Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of  having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi

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