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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 Dec 01 2019
Journal Name
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Sun Dec 02 2012
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Publication Date
Sun Jun 30 2024
Journal Name
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The Image of the Arab in Hebrew Literature for Young Adults – A Reading of the Novel “Nadia” by Kalila Ron Feder
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Publication Date
Tue Nov 24 2020
Journal Name
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Thermal performance of a flat-plate solar collector using aqueous colloidal dispersions of multi-walled carbon nanotubes with different outside diameters
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Publication Date
Thu Feb 01 2024
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Organic soil is problematic soils in geotechnical engineering due to its properties, as it is characterized by high compressibility and low bearing capacity. Therefore, several geotechnical techniques tried to stabilize and improve this soil type. In this study, sodium silicate was used to stabilize sand dune columns. The best sodium silicate concentration (9%) was used, and the stabilized sand dune columns were cured for seven days. The results for this soil were extracted using a numerical analysis program (Plaxis 3D, 2020).In the case of studying the effect of (L/D) (where ‘’L” and ‘’D’’ length and diameter of sand dune columns) of a single column of sand dunes stabilized with sodium silicate with a diff

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Mon May 25 2026
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Publication Date
Thu Oct 01 2020
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Publication Date
Sun Sep 15 2019
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Publication Date
Tue Mar 01 2016
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Harmonization formative in the design of interior spaces Hall of discussions in the design department (a model): بدريا محمد حسن فرج
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