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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 Jan 01 2023
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees22fr
Preparation and study the partial substitution of aluminum with copper on some physical properties of the compound TlSr2Ca2Cu3O8+δ
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
A Comparison Between the Theoretical Cross Section Based on the Partial Level Density Formulae Calculated by the Exciton Model with the Experimental Data for (_79^197)Au nucleus
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In this paper, the theoretical cross section in pre-equilibrium nuclear reaction has been studied for the reaction  at energy 22.4 MeV. Ericson’s formula of partial level density PLD and their corrections (William’s correction and spin correction) have been substituted  in the theoretical cross section and compared with the experimental data for  nucleus. It has been found that the theoretical cross section with one-component PLD from Ericson’s formula when  doesn’t agree with the experimental value and when . There is little agreement only at the high value of energy range with  the experimental cross section. The theoretical cross section that depends on the one-component William's formula and on-component corrected to spi

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Publication Date
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Genotoxicity of the Aerial Parts of Iraqi Euphorbia cyathophora on Bone Marrow and Spleen Cells in Mice
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The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice  200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr

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Publication Date
Mon Sep 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Histological and immunohistochemical evaluation of the effect of local exogenous application of VEGF on bone healing (experimental study in rat)
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Background: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this study. This study aimed to identify the role of local exogenous vascular endothelial growth factor in bone healing and to analyze the expression of VEGF by immunohistochemistry in created bone defect af

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Publication Date
Sun Feb 25 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
10.28936 PARTIAL PURIFICATION OF BACTERIOCIN PRODUCED FROM PEDIOCOCCUS ACIDILACTICI-FMAC278 AND WEISSELLA PARAMESENTEROIDES-DFR6 AND ITS APPLICATION IN THE PRESERVATION OF CHICKEN SAUSAGES: PARTIAL PURIFICATION OF BACTERIOCIN PRODUCED FROM PEDIOCOCCUS ACIDILACTICI-FMAC278 AND WEISSELLA PARAMESENTEROIDES-DFR6 AND ITS APPLICATION IN THE PRESERVATION OF CHICKEN SAUSAGES
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Bacteriocins were partially purified by ammonium sulphate 50% concentraction, bacteriocin activity of Pediococcus acidilactici-FMAC278 was 25600 U/ml with 5.8 folds and 7.6% yeild, the activity decrease to 12800 U/ml after dialysis with 6.3 folds and 3% yield, On the other hand the bacteriocin activity of Weissella paramesenteroides-DFR6 was 12800 U/ml with 2.7 folds and 8.8% yeild, after dialysis the activity became 6400 U/ml with 5.1 fold and 3.4% yield, Chicken Sausage were made by adding 0.25, 0.5 and 1% particaly purified bacteriocin to study its effect on microorganisms and increasing shelf life of Sausage. It is found that bacterial numbers were decreased after 3 days of storage at refrigerator at 0.5% conc. While the molds decrea

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Publication Date
Mon Mar 04 2024
Journal Name
Journal Of Emergency Medicine, Trauma And Acute Care
Cone beam computed tomography (CBCT) evaluation of ridge shape and bone density in Iraqi sample pre-dental implant insertion
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One of the critical factors for dental implant success is accurate clinical and radiological assessment. Cone-beam computed tomography systems (CBCT) allow surgeons to determine the quality and quantity before surgery, aiding in treatment planning. This study highlights the importance of such an assessment Materials and Methods A total of 40 patients were referred to CBCT scanning for pre-dental implant assessment in the Oral and Maxillofacial Radiology department at Al-Shaheed Gazi Al Hariri Hospital from 2021 to 2022. The patients were between 18 and 50 years old. All data were analyzed with on-demand 3D software (Kavo OP 3D: Cone Beam 3D imaging Germany). Results: Regarding the ridge shape: In the upper anterior and posterior regions, th

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Publication Date
Wed Nov 11 2020
Journal Name
Journal Of Research In Medical And Dental Science
Effect of Topical Melatonin Application on the Peri-Implant Proximal Bone Level and Cortical Plate Thickness (Pilot Clinical Trial)
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Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Evaluation the Effect of 805 nm Wavelength Diode Laser on Repair of Mandibular Bone Repair and Skin Incisions in Rabbits
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The long healing time of bone after tooth extraction in order to construct artificial teeth is uncomfortable to the patient because of aesthetic or masticatory problems in addition to the daily visit to dental clinic. The objective of this study was to evaluate the effect of 805 nm diode laser with long time intervals on repair of bone and skin incisions in rabbits through biochemical, radiological and histological findings. Eighteen New-Zealand rabbits were undergone surgical operations to make a cavity in the bone of the lower jaw, the rabbits were divided into two groups:- Group A (control group) containing nine rabbits. Group B (lased group) containing nine rabbits in which two cavities were done, one on the right side and the other

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Publication Date
Mon Dec 20 2021
Journal Name
Journal Of Craniofacial Surgery
The Effect of Bone Density Measured by Cone Beam Computed Tomography and Implant Dimensions on the Stability of Dental Implants
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Abstract: The aim of this study was to evaluate the effect of bone density value in Hounsfield unit derived from cone beam computed tomography (CBCT), and implant dimensions in relation to implant stability parameters namely the resonance frequency analysis and the insertion torque (IT) value. It included 24 patients who received 42 dental implants (DI). The bone density of the planned implant site was preoperatively measured using cone beam computed tomography. The implant stability was measured using Osstell implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. The IT value was categorized as 35 N/cm or > 35 N/cm. The mean (standard deviation) primary stability was 79.58 (5.27) ISQ,

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Impact of omega 3 alone or in combination with irinotecan on bone marrow and spleen of rats: in vivo study
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Abstract

Objectives: The present study designed to explore the genotoxicity through measurement of Mitotic index in bone marrow and the spleen cells, as possible mechanism of bone marrow and spleen toxicity that induced by irinotecan; and to describe the protective actions of omega 3 against irinotecan induced genotoxicity in bone marrow and the spleen of rats.

Methods: Twenty four (24) rats (Sprague-Dawley) were randomly divided into four groups: Group Ӏ, rats  received single oral daily dose of distilled water (2 ml/kg) for 25 days (negative control group); Group ӀӀ (irinotecan-treated), receiv

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