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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 Dec 02 2012
Journal Name
Baghdad Science Journal
Estimation Activity And Partial Purification Of Leucine Amino Peptidase (Lap) In Patients Wiith Diabetic Nephropathy
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Leucine aminopepotidase (LAP)[EC:3.4.11.1] activity has been assayed in (50) serum samples of patients with diabeties naphrophathy D.N (non-insulin dependent diabetic (NIDD) , and (50)serum sample of healthy individuals without any clinically detectable diseases have been as control group. The aim of this study is to measure leucine aminopeptidase activity and partially purifying the enzyme from sera of patients with diabetes nephropathy The results of this study revealed that Leucine aminopeptidase (LAP) activity of nephropathy patient’s serum shows a high signifiacant increase (p < 0.001) compared to that of the healthy subjects.LAP was purified from the serum of patients with diabetes nephropathy by dialysis and gel filtration (Se

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Effect of partial substitution of alkaline oxides with lithium oxide (Li2O) on low-temperature ceramic glaze
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The research aims to study the effect of adding (Li2O) to an alkaline glaze containing (K2O, Na2O). Although all the alkaline oxides have common properties, each oxide has something that distinguishes it. The molecular weight of (Li2O) is two times less than that of (Na2O) and three times that of (K2O). Therefore, it is added in small proportions. In addition, it is a very strong flux, so it is not used alone, but rather replaces a part of other alkaline oxides. It was added to an alkali glass that matured at a temperature of 980CO in proportions (2.0,1.4,1.2,0.8,0.4%) instead of (Na2O), using lithium carbonate (Li2CO3) as an oxide source. The glazes mixtures were applied to a white pottery body, and the samples were fired and cooled acc

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Publication Date
Sat Jul 08 2017
Journal Name
Research Journal Of Pharmaceutical , Biological And Chemical Sciences
Assessment activity and Partial purification of Alkaline phosphatase (AIP) from sera of patients with celiac disease
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Publication Date
Sat Feb 18 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Knowledge, Perception, and Reporting Practices of Healthcare Providers about Adverse Events Following the COVID-19 Vaccination in Iraq(Conference Paper )#
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  Routine vaccination activities, such as detection, reporting, and management of adverse events following immunization (AEFIs), are generally handled by healthcare providers (HCPs). Safe vaccines against severe acute respiratory syndrome coronavirus (SARS-CoV-2) were introduced to control the Coronavirus Disease-19 (COVID-19) pandemic. The study aimed to assess the knowledge, perceptions, and practice of HCPs in Iraq about reporting adverse events following COVID-19 vaccination, and their association with sociodemographic variables. The study was a cross-sectional study that was carried out between August and September 2021 at the COVID-19 vaccination centers in Iraq. This study used an online and paper-based questionnaire, which

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
A study of Fermi hole and partial Fermi hole for Li- and C-Atoms in different states 1s 2p, 1s 3p, 1s 3d and 2s 2p
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The electron correlation effect for inter-shell have been analysed in terms of Fermi hole and partial Fermi hole for Li-atom in the excited states (1s2 3p) and (1s2 3d) using Hartree-Fock approximation (HF). Fermi hole Δf(r12) and partial Fermi hole Δg(r12 ,r1) were determined in position space. Each plot of the physical properties in this work is normalized to unity. The calculation was performed using Mathcad 14 program.

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Publication Date
Sat Sep 24 2022
Journal Name
International Journal Of Biomaterials
Histological Evaluation of the Effect of Local Application of Punica granatum Seed Oil on Bone Healing
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Background. Bone healing is a complex and dynamic process that represents a well-orchestrated series of biological events of cellular recruitment, proliferation, and differentiation. The use of medicinal plants in bone healing has attracted increasing interest because of their lower side effects. Punica granatum seed oil (PSO) contains high levels of phenolic compounds, promotes osteoblast function, and plays an important role in bone remodeling. A gelatin sponge (Spongostan) is a hemostatic agent that is extensively applied as scaffolds in engineering and as drug carriers in the medical field. This study aimed to evaluate the effectiveness of PSO for bone healing enhancement. Twenty adult male New Zealand rabbits, weighing an avera

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Publication Date
Wed Jun 01 2022
Journal Name
World Neurosurgery
Letter to the Editor “Challenges of Meeting Cerebrovascular Surgery Demands in Low-and Middle-Income Countries: An Experience from Iraq”
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Publication Date
Tue Apr 15 2025
Journal Name
Journal Of Neonatal Surgery
Resveratrol Administration Reverses The Osteoporotic Bone In Independent-Manner Of Ahr-Esr1 Axis In Rats
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The objective  of this work was to analyze the involvement of AhR in bone metabolism using a rat model of experimental osteoporosis and to analyze the mechanisms behind its activity. Rats were assigned randomly to the subsequent groups; Control, received no treatment; ovariectomized (OVX) rats; Sham; Sham+RES received resveratrol; OVX+RES and OVX+CH received AhR’s antagonist, CH223191 (CH); and finally OVX+CHR group received both AhR antagonist along with resveratrol. Resveratrol and AhR antagonist treatment started 7 days after surgery and continued to 45 days. The serum of osteocalcin (OC) and Ca+2  was measured by ELISA and spectrophotometer, respectively. X-ray was used to estimate bone density of rats. In molecular levels,

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Publication Date
Mon Jul 10 2023
Journal Name
Journal Of Engineering
Uptake of Fluoride from Water Using Recycled Raw Beef Bone as an Environmently Freindly Waste
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Excessive intake of fluoride, mainly through drinking water is a serious health hazard affecting humans worldwide. In this study, the defluoridation capacities of locally available raw waste beef bones have been estimated. Several experimental parameters including contact time, pH, bone dose, fluoride initial concentration, bone grains size, agitation rate, and the effect of co-existence of anions in actual samples of wastewater were studied for fluoride removal from aqueous solutions. Results indicated excellent fluoride removal effeciency up to 99.7% at fluoride initial concentration of 10 mg F/L and 120 min contact time. Maximum fluoride uptake was obtained at neutral pH range 6-7. Fluoride removal kinetic was well described by the ps

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Non Traumatic Hip Osteonecrosis Treated By Non Vascularised Bone Graft Versus Core Decompression
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Background: Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years.Treatment of a vascular necrosis depends mainly on early diagnosis which mainly base

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