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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
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Chitotriosidase level as a Novel Biomarker for Therapeutic Monitoring of Nephropathic Cystinosis among the Iraqi children
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Background: Cystinosis is a rare autosomal recessive lysosomal storage disease with high morbidity and mortality. It is caused by mutations in the CTNS gene that encodes the cystine transporter, cystinosin, which leads to lysosomal cystine accumulation. It is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. Elevated white blood cell cystine content is the cornerstone of the diagnosis. Since chitotriosidase (CHIT1 or chitinase-1) is mainly produced by activated macrophages both in normal and inflammator

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Publication Date
Mon Jan 01 2018
Journal Name
Pakistan Journal Of Medical & Health Sciences
Prevalence of Peripheral Arterial Disease in End Stage Renal Disease Patients Undergoing Hemodialysis: A Cross-Sectional Study
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The chronic renal disease is a principle common medical dilemma in Iraq. Peripheral arterial disease (PAD) is a prevalent infirmity in the hemodialysis people. The aim of present study was to estimate the prevalence of PAD in subjects with end-stage renal disease (ESRD). This cross-sectional study was done between January 2016 and May 2017 on ESRD subjects regularly attending renal dialysis unit in Al-Kindy teaching hospital in Baghdad, Iraq. PAD was diagnosed on the base of the ankle-brachial index (ABI) measured by using a hand-held Doppler ultrasound. Subjects with ABI ≤0.9 were supposed positive for PAD. A total of 150 ESRD cases were analyzed. The mean age of the subject was 49.52±15 years. Majority of them were males 87(58%). Most

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Publication Date
Sun May 17 2026
Journal Name
Journal Of Physical Education
A study of some variables biomechanics in clean and jerk for the world champions men and women
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Publication Date
Mon Jan 01 2024
Journal Name
Wiadomości Lekarskie
Evaluation of clinical and demographical finding in patients with oral lichen planus: A retrospective cross sectional study
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Aim: To learn more about Oral Lichen Planus Iraqi patients, including their background information, symptoms, and prognosis. Materials and Methods: From the Oral and Maxillofacial Pathology Department, College of Dentistry, Baghdad University, we retrospectively reviewed the medical records of 68 patients with a histologically confirmed clinical diagnosis of oral lichen planus and subsequently contacted the patients by phone to evaluate their prognosis. Results: Females were more likely than males to experience severe pain; the reticular form of Oral Lichen Planus was the most prevalent at 38.2%, but the erosive type was more prevalent among females. Only 53 of 68 patients responded to phone calls. More than 37% of those respondents reporte

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of a Mediator on Scaffolding EFL Student Teachers’ Teaching Competencies, Self- Efficacy and Self–Awareness
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This study aims to find out the effect of the mediator on scaffolding fourth yearstudent- teachers' teaching competencies and their self-efficacy. The present study combines scaffolding and self-efficacy by using a mediator on scaffolding students affects teaching competencies and selfefficacy and from the results of which the existence of student-teachers’ selfawareness was ensured as an effect of the same independent variable. The model affects their teaching competencies and led them to be aware of the needs of their pupils and themselves. 

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Publication Date
Mon Dec 01 2014
Journal Name
Al-mansour Journal /issue( 22 )
A Thematic Reading of John Bunyan's The Pilgrim's Progress with Introductory References to Islam in English Literature
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The importance of this study lies in shedding the light on the impact of Islam and Prophet Mohammed (peace be upon him) on the western culture and English literature in particular. While some writers were looking at Islam as a dangerous element, others were completely taken by the oriental spirit of Arabic and Islamic culture and glorifying it. Writers from Chaucer to later ones mostly make references to this impact showing how vast was the gap of misunderstanding between the east and the West. Thus, this study aims at breaking the barrier between East and West in its three sections as it introduces the meaning of Islam and its common features with other religions in the first section. The second section briefly presents writers’ reflecti

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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
Methods of Acting Performance and Watching Industry in Street Theatre- Play (Sold) - A Model: بهاء زهير كاظم
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  The audience is one of the important practical elements in the theatrical show and its importance is not confined to its static activity as a receiver element only, rather it went beyond that issue as an effective and influential element in the proceedings of the show and the process of meaning construction, that it gains an active role in the construction and production of the connotation that influences and is influenced by the actor, where the communication channels are open between the two sides, consequently a kind of watching and joint interaction happens between them. Thus, it has become necessary for the actor to create a suitable environment for the onlookers in order for it to be an essential part of the show system. The

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Publication Date
Sat Feb 05 2022
Journal Name
Applied Nanoscience
RETRACTED ARTICLE: The impact of fear on a stage structure prey–predator system with anti-predator behavior
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A prey-predator interaction model has been suggested in which the population of a predator consists of a two-stage structure. Modified Holling's disk equation is used to describe the consumption of the prey so that it involves the additional source of food for the predator. The fear function is imposed on prey. It is supposed that the prey exhibits anti-predator behavior and may kill the adult predator due to their struggle against predation. The proposed model is investigated for existence, uniqueness, and boundedness. After determining all feasible equilibrium points, the local stability analyses are performed. In addition, global stability analyses for this model using the Lyapunov method are investigated. The chance of occurrence of loc

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Publication Date
Wed Jul 01 2020
Journal Name
Plant Archives
a study about some biological aspects of invasive molly fish “poecilia latipinna” (lesueur, 1821) in southern iraq
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Publication Date
Fri Jan 01 2021
Journal Name
Desalination And Water Treatment
Removal of nitrates from water by Amberlite IR-400 and economic Duolite A-378 ion exchange resins
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