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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 Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Exploring the Capability of the Hospital Pharmacists in Conducting Pharmacy Practice Research: A Study from Malaysia
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The engagement of pharmacists in research activities is pivotal in the advancement of the pharmacy practice. The study aims to evaluate the confidence and competence of Malaysian hospital pharmacists in conducting clinical and practice-based research.

A cross-sectional study was carried out between September 2019 and April 2020 using an online survey. Pharmacists from eight different hospitals in Malaysia were involved in the study. The survey link was sent to all pharmacists of the included hospitals via email. Data were analysed using SPSS version 25.

A total of 226 pharmacists participated in this study, and their average age was 28 years old. About 82 % of the participants reported that they did not have any previous re

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Engineering
Unit Price and Cost Estimation Equations through Items Percentage of Construction Works in a Desert Area
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This research will cover different aspects of estimating process of construction work in a desert area. The inherent difficulties which accompany the cost estimating of the construction works in desert environment in a developing country, will stem from the limited information available, resources scarcity, low level of skilled workers, the prevailing severe weather conditions and many others, which definitely don't provide a fair, reliable and accurate estimation. This study tries to present unit price to estimate the cost in preliminary phase of a project.  Estimations are supported by developing mathematical equations based on the historical data of maintenance, new construction of managerial and school projects.

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Publication Date
Sun Dec 01 2019
Journal Name
Ieee Xplore
A Hybrid Modified Lightweight Algorithm Combined of Two Cryptography Algorithms PRESENT and Salsa20 Using Chaotic System
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Cryptography algorithms play a critical role in information technology against various attacks witnessed in the digital era. Many studies and algorithms are done to achieve security issues for information systems. The high complexity of computational operations characterizes the traditional cryptography algorithms. On the other hand, lightweight algorithms are the way to solve most of the security issues that encounter applying traditional cryptography in constrained devices. However, a symmetric cipher is widely applied for ensuring the security of data communication in constraint devices. In this study, we proposed a hybrid algorithm based on two cryptography algorithms PRESENT and Salsa20. Also, a 2D logistic map of a chaotic system is a

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Publication Date
Tue Feb 13 2018
Journal Name
Journal Of Optics
Solar selective performance of metal nitride/oxynitride based magnetron sputtered thin film coatings: a comprehensive review
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Publication Date
Wed Dec 01 2021
Journal Name
Open Biology
Structure and in silico simulations of a cold-active esterase reveals its prime cold-adaptation mechanism
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Here we determined the structure of a cold active family IV esterase (EstN7) cloned from Bacillus cohnii strain N1. EstN7 is a dimer with a classical α/β hydrolase fold. It has an acidic surface that is thought to play a role in cold-adaption by retaining solvation under changed water solvent entropy at lower temperatures. The conformation of the functionally important cap region is significantly different to EstN7's closest relatives, forming a bridge-like structure with reduced helical content providing greater access to the active site through more than one substrate access tunnel. However, dynamics do not appear to play a major role in cold adaption. Molecular dyn

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Publication Date
Wed Jan 02 2019
Journal Name
Differential Equations And Dynamical Systems
Stability and Bifurcation in a Prey–Predator–Scavenger System with Michaelis–Menten Type of Harvesting Function
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Publication Date
Sat Jun 01 2024
Journal Name
Applied Thermal Engineering
Design and optimization of a household photovoltaic/thermal collector with serpentine tube: Energy and exergy analysis
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Publication Date
Mon Oct 16 2023
Journal Name
International Journal Of Phytoremediation
Adsorption of methyl orange on low-cost adsorbent natural materials and modified natural materials: a review
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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Study of Corrosion Inhibition for Mild Steel in Hydrochloric Acid Solution by a new furan derivative
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Abstract<p>The corrosion inhibition effect of a new furan derivative (furan-2-ylmethyl sulfanyl acetic acid furan-2-ylmethylenehydrazide) on mild steel in 1.0 M HCl was investigated using corrosion potential (ECORR) and potentiodynamic polarization. The obtained results indicated that the new furan derivative (furan-2-ylmethyl sulfanyl acetic acid furan-2-ylmethylenehydrazide) (FSFD) has a promising inhibitive effects on the corrosion of mild steel in 1.0 M HCl across all of the conditions examined. The density functional theory (DFT) study was performed on the new furan derivative (FSFD) at the B3LYP/6-311G (d, p) basis set level to explore the relation between their inhibition efficiency and molecular electro</p> ... Show More
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Publication Date
Sun Feb 01 2026
Journal Name
Materials Today Communications
Tuning radiation attenuation performance of W-substituted nano-BiNb₁₋ₓWₓO₄ ceramics: A Monte Carlo simulation approach
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