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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
Tue Jan 28 2014
Journal Name
Toxins
Co-occurrence of the Cyanotoxins BMAA, DABA and Anatoxin-a in Nebraska Reservoirs, Fish, and Aquatic Plants
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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
The Role of Binary Settings in John Updike’s Short Stories: A Structuralist Approach: مؤيد انوية ججو الجماني
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John Updike’s use of setting in his fiction has elicited different and even conflicting reactions from critics, varying from symbolic interpretations of setting to a sense of confusion at his use of time and place in his stories.  The present study is an attempt at examining John Updike’s treatment of binary settings in Pigeon Feathers and Other Stories (1962) to reveal theme, characters’ motives and conflicts.  Analyzing Updike’s stories from a structuralist’s perspective reveals his employment of two different places and times in the individual stories as a means of reflecting the psychological state of the characters, as in “The Persistence of Desire”, or expressing conflicting views on social and political is

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Publication Date
Thu Dec 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Electrolytic removal of zinc from simulated chloride wastewaters using a novel flow-by fixed bed electrochemical reactor
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The cathodic deposition of zinc from simulated chloride wastewater was used to characterize the mass transport properties of a flow-by fixed bed electrochemical reactor composed of vertical stack  of stainless steel nets, operated in batch-recycle mode. The electrochemical reactor employed potential value in such a way that the zinc reduction occurred under mass transport control. This potential was determined by hydrodynamic voltammetry using a borate/chloride solution as supporting electrolyte on stainless steel rotating disc electrode. The results indicate that mass transfer coefficient (Km) increases with increasing of flow rate (Q) where .The electrochemical reactor proved to be efficient in removing zinc and was abl

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Publication Date
Sat Mar 01 2008
Journal Name
Al-khwarizmi Engineering Journal
The Effects of Vortex Generator Types on Heat Transfer and Flow Structure in a Rectangular Duct Flows
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    In this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n

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Publication Date
Fri Aug 01 2025
Journal Name
مجلة الترجمة واللسانيات
A Linguistic Study of Russian and American Accusations over Ukraine دراسة لغوية للاتهامات الروسية والامريكية حول اوكرانيا
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This study presents a linguistic analysis of how Russian and American mainstream media and official statements deployed speech acts of accusation during the 2022 Russian invasion of Ukraine. Using Speech Act Theory (Austin, 1962; Searle, 1976) as the framework. The study analyzes 50 texts of English-language official statements and media headlines from both sides. In this research utterances are categorized into assertives, expressives, directives, commissives, and declarations, and analyzes their pragmatic force in shaping narratives. The analysis reveals contrasts in tone and rhetorical strategy: U.S. officials and media overwhelmingly use assertive accusations and expressive condemnations to morally indict Russia, while Russian counterpa

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
Religious references to art of miniatures In the Iranian school (Behzad is a model): عبدالرزاق جبار رحيل
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The study examines the religious references of the art of miniatures in the Iranian school "Bahzad model" completed in Iran during the twelfth century AH, according to the controls and characteristics of the authoritative references. The researcher presented the problem of research, its importance, the need for it and its purpose, defined the terms in the research. The theoretical framework came with three investigations. The first topic of the concept of the reference in the field of knowledge, which concluded the most important features of the reference, is that each symbolic existence corresponds to a real existence and symbolic presence is an input to the realization of the reference. The reference then becomes a sign that acts as a

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Publication Date
Sun May 17 2026
Journal Name
Retos: Nuevas Tendencias En Educación Física, Deporte Y Recreación, Issn-e 1988-2041, Issn 1579-1726, Nº. 68, 2025, Págs. 1048-1062
The impact of knowledge management on cognitive achievement in sports science: A case study in boxing education
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Introduction: Knowledge management plays a crucial role in students’ ability to acquire, organize, retrieve, and apply information, impacting academic performance. In sports sciences, especially in combat sports like boxing, effective knowledge management supports both theoretical understanding and practical skill application. Despite exposure to boxing through training and media, students’ academic performance remains inconsistent. Objective: This study examines the relationship between knowledge management and cognitive achievement among second-year students in the College of Physical Education and Sport Sciences at the University of Basrah. It evaluates how students manage knowledge and its impact on their retention and application

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Publication Date
Sun May 17 2026
Journal Name
Journal Mustansiriyah Of Sports Science
The Effect of Ocular Reflex Exercises Using a Proposed Device on Eyes - Hands Coordination for Junior Boxers
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Publication Date
Wed Oct 16 2019
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Depression, Anxiety and Stress Among a Sample of Chronic Hepatitis C Patients in AL-Najaf Province /Iraq
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Previous studies in Euro-American countries have shown that patients with chronic hepatitis C virus infection have increased levels of neuropsychiatric symptoms. While chronic hepatitis C virus infection has been reported in Arab countries such as Iraq, there is little studies about the neuropsychological burden associated with chronic hepatitis C among patients in the Arab region. The aim of the current study was to measure the prevalence and level of severity of depression, anxiety and stress among a sample of chronic hepatitis C patients in AL-Najaf province /Iraq. The current study was cross-sectional study carried out on (110) already diagnosed chronic viral hepatitis C patients who attended the Gastroenterology and Hepatology

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Publication Date
Mon May 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Screening and optimization of a novel gallic acid and tannase production under semi quantitative and quantitative methods
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Abstract<p>Tannin acyl hydrolase as the common name of tannase is an inducible extracellular enzyme that causes the hydrolysis of galloyl ester and depside bonds in tannins, yielding gallic acid and glucose. The main objective of this study is to find a novel gallic acid and tannase produced by <italic>Acinetobacter Baumannii</italic>. A number of optimization steps were followed in order to improve the highest production of gallic acid and tannase. In present study, <italic>A. baumannii</italic> were isolated from ICU burn. <italic>A. baumannii</italic> was examined by microscopic examination, morphological and biochemical assay including oxidase and catalase. The </p> ... Show More
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