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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 Jun 21 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Incidence of Genotoxic Effects of Artificial Food Favoring Additives in Bone Marrow Cells and Spleen Cells in Mice
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Genetic material is the most important component of cells because it contains the genetic information; hence any disruption to the structure chromosome of cells could lead to very bad results. Genotoxicity use to evaluate the safety of any chemical compounds on genetic materials. Artificial food flavoring additive are chemical substances to produce specific placebo effects added to foods but impart specific flavor to it.

The present study evaluates the genotoxic effect of artificial food flavoring additive on structure of chromosomes at three different concentrations (50%, 100%and 150%) on both bone marrow cells and spleen cells in mice for fourteen successive days. It was found that artificial food flavoring addit

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Reflection of the audit of contracts according to "related services" on the report of the auditor: applied research in Palestine International Hotel Company / shareholding company
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The issue of auditing contracts according to the related services is one of the important topics It has also become necessary to develop traditional procedures and auditing according to international standards to improve the profession of accounting and auditing. From this standpoint, the research aims to indicate the reflection of the contracting audit in accordance with the related services on the auditor's report. in line with the new directions regarding the need to adopt international standards in the Iraqi environment as the research problem focused on the non-comprehensiveness of the audit programs that deal with auditing contracts according to assurance commitments to contribute obtaining Governing evidence, The research

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Buccal Cortical Bone Thickness in Iraqi Arab Adults by Cone Beam Computed Tomography for Orthodontic Mini-Implants
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ABSTRACT Background: Cortical bone thickness is important for the stability of mini implants. Placing mini implants in sites of favorable cortical bone thickness would guarantee better initial stability and long-term success. The aim of this study was to investigate gender, side and jaw differences of the buccal cortical bone thickness as a guide for orthodontic mini screw placement. Materials and Methods: The sample was selected from the patients attending the Specialized Health Center in Al-Sadr City / 3D department. Thirty patients (15 males and 15 females) were selected and cone beam computerized tomographic images were done. Then the buccal cortical bone thickness was measured at thirteen inter radicular sites in the maxilla and mandib

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Reasons for Partial Compliance and Non-compliance to the Routine Childhood Vaccination Schedule in Al-Karkh District
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Abstract

      Objective (s): To evaluate reasons for partial compliance and non-compliance to the

                              routine childhood vaccination schedule in Al-Karkh district 

Methodology: Descriptive study , using the evaluation approach, is carried throughout the present study to determine the reasons for the Routine Childhood Vaccination at  health care sectors and primary health care centers at  Al-Karkh District in Baghdad City, Convenient, non-probability, sample of (90) mother who are recruited from health care sectors at Al-Karkh District in Baghdad City. All mothers, who ha

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Publication Date
Sun Jun 02 2024
Journal Name
Methods And Objects Of Chemical Analysis
Simultaneous Spectrophotometric Determination of Piroxicam, Naproxen, Diclofenac Sodium and Mefenamic Acid in Pharmaceutical Formulations by Partial Least Squares Method
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A chemometric method, partial least squares regression (PLS) was applied for the simultaneous determination of piroxicam (PIR), naproxen (NAP), diclofenac sodium (DIC), and mefenamic acid (MEF) in synthetic mixtures and commercial formulations. The proposed method is based on the use of spectrophotometric data coupled with PLS multivariate calibration. The Spectra of drugs were recorded at concentrations in the linear range of 1.0 - 10 μg mL-1 for NAP and from 1.0 - 20 μg mL-1 for PIR, DIC, and MEF. 34 sets of mixtures were used for calibration and 10 sets of mixtures were used for validation in the wavelength range of 200 to 400 nm with the wavelength interval λ = 1 nm in methanol. This method has been used successfully to quant

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Publication Date
Sat Nov 16 2019
Journal Name
Journal Of Global Pharma Technology
Partial purification of leucine aminopeptidase and its correlation with some biochemical parameters in sera of subclinical hyperthyroidism and hyperthyroidism patients.
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he study aimed to purify of Leucine aminopeptidase (LAP) from sera of hyperthyroidism patients and its relation to some thyroid hormones (TSH, T 3 , T 4 ) of subclinical hyperthyroidism and hyperthyroidism patients with lipid peroxidation levels that may be play a role in this diseases. Specimens were collected during the time from Nov 2017 until Jan 2018 from Endocrine and Diabetes Center, blood samples were collected from fifty healthy control and one hundred patients, patients were divided into two groups consisted of (50) with hyperthyroidism and (50) with subclinical hyperthyroidism. The aged for all subjects ranged (15-60) years with body mass ranged ((25- 29) kg/m 2 . The purification is done by addition of ammonium sulfate, dial

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Publication Date
Tue Dec 05 2023
Journal Name
Engineering, Technology & Applied Science Research
The Fire Effect on the Performance of Reinforced Concrete Beams with Partial Replacement of Coarse Aggregates by Expanded Clay Aggregates
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This paper aims to investigate the flexural behavior of reinforced concrete beams considering fire resistance by adding Lightweight Expanded Clay Aggregates (LECA) to the concrete mix as partial coarse aggregate replacement. LECA is a type of porous clay with a uniform pore structure with fine, closed cells and hard, tightly sintered skin. The experimental work comprised four reinforced self-compacted concrete beams. All the specimens were identical in their geometrical layout of 1600×240×200 mm, reinforcement details, and support condition (simply supported). For all the beams, the main reinforcement was provided by two bars, each having a diameter of 12 mm, while a bar of 6 mm diameter was employed for the top and shear reinforc

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Publication Date
Tue Jan 18 2022
Journal Name
Materials Science Forum
Effect Partial Substitution of Calcium by <i>Cadmium</i> on Dielectrically Properties of Li0.4Cd0.6Ba2Ca2Cu3O10+δ System
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In this article the conventional "solid-state reaction" method was used to synthesize perovskite Li0.4Cd0.6Ba2Ca2Cu3O10+δ. Four main types of compounds were obtained by physically replacing calcium oxide with cadmium in proportions 0, 0.03, 0.06 and 0.09, the pure Li0.4Cd0.6Ba2Ca2Cu3O10+δ phase, and the phases Li0.4Cd0.6Ba2Ca1.97Cd0.03Cu3O10+δ

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Publication Date
Mon Sep 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of AcceleDent® Device on Both Gingival Health Condition and Levels of Salivary Interleukin-1-βeta and Tumor Necrosis Factors-Alpha in Patients under Fixed Orthodontic Treatment
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Background: Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva.The purpose of this study was to evaluate the activity of alkaline phosphatase (ALP) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces. Materials and Methods: Thirty orthodontic patients (12 males and 18 females) aged 17-23 years with class II division I malocclusion all requiring bilateral maxillary first premolar extractions were randomly divided into three groups according to t

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Publication Date
Mon Sep 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Cone Beam Computed Tomography in an Evaluation and Diagnosis of Anatomical Variations and Pathological Lesions in Maxillary Sinus Prior to Maxillary Sinus Lift Surgery
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Abstract: Thorough assessment of the Maxillary,Sinus is very important. Recently 3-dimensional imagewith Cone Beam Computed Tomography (CBCT) is very dependable in Maxillary Sinus diagnosis. The aim of this study is to: shade light on the role of (CBCT) diagnosis of the maxillary sinus anatomical variation and pathological finding among smokers and nonsmokers prior to maxillary sinus lift techniques. Materials and Method: In this study 60 males with age ranged between 20-50 years old, referred for (CBCT) assessment of maxillary sinus in the Specialist Health Center of AL-Sadder city. The scanning were performed using Kodak 9500 (CBCT), the KV was 90, mA10 and scanning time 10 s. Voxel size 0.3mm with( DICOM ) software on a multiplaner re

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