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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
Wed Apr 01 2020
Journal Name
2020 International Conference On Computer Science And Software Engineering (csase)
Implementing a Super Decisions Software (SDS) in a Transport Sector
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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Surgical Case Reports
A rare variant of mirror hand deformity
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Congenital hand and forearm anomalies pose a unique challenge in plastic and pediatric surgery. We present a case report of an 8- months-old girl with a congenital left sided hand and forearm anomaly, provisionally diagnosed as atypical left mirror hand anomaly. Classically there is absence of radius and duplication of ulna; however, our case had normal radius and ulna and a hand with seven digits arranged in two groups. We did a surgery which involved a ray amputation of the finger ulnar to the most radial digit, aiming to preserve an adequate first web space to reconstruct the thumb. The result of the surgical treatment in both functional and cosmetic aspects was, in authors’ opinion, good.

Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Optimization of Drilling Well Design: A Review
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Drilling well design optimization reduces total Authorization for Expenditures (AFE) by decreasing well constructing time and expense. Well design is not a constant pattern during the life cycle of the field. It should be optimized by continuous improvements for all aspects of redesigning the well depending on the actual field conditions and problems. The core objective of this study is to deliver a general review of the well design optimization processes and the available studies and applications to employ the well design optimization to solve problems encountered with well design so that cost effectiveness and perfect drilling well performance are achievable. Well design optimization processes include unconventional design(slimhole) co

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Publication Date
Wed Sep 12 2012
Journal Name
Journal Of Engineering
Design and Implementation of a Vlsm Simulator
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Variable-Length Subnet Masks (VLSM), often referred to as "subnetting a subnet", is used to maximize addressing efficiency. The network administrator is able to use a long mask on networks with few hosts, and a short mask on subnets with many hosts. This addressing scheme allows growth and does not involve wasting addresses. VLSM gives a way of subnetting a network with minimal loses of IP addresses for a specific range. Unfortunately, the network administrator has to perform several mathematical steps (or use charts) to get the required results from VLSM. In this paper, a simple graph simulator is proposed (using Visual Basic 6.0 Language) to perform all the required mathematical steps and to display the obtained required information (the

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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
Properties of a Complete Fuzzy Normed Algebra
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          The aim of this paper is to translate the basic properties of the classical complete normed algebra to the complete fuzzy normed algebra at this end a proof of multiplication fuzzy continuous is given. Also a proof of every fuzzy normed algebra  without identity can be embedded into fuzzy normed algebra  with identity  and  is an ideal in  is given. Moreover the proof of the resolvent set of a non zero element in complete fuzzy normed space is equal to the set of complex numbers is given. Finally basic properties of the resolvent space of a complete fuzzy normed algebra is given.

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Publication Date
Thu Jan 01 2015
Journal Name
Algebra Letters
THE GRAPH OF A COMMUTATIVE KU-ALGEBRA
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In This paper, we introduce the associated graphs of commutative KU-algebra. Firstly, we define the KU-graph which is determined by all the elements of commutative KU-algebra as vertices. Secondly, the graph of equivalence classes of commutative KU-algebra is studied and several examples are presented. Also, by using the definition of graph folding, we prove that the graph of equivalence classes and the graph folding of commutative KU-algebra are the same, where the graph is complete bipartite graph.

Publication Date
Wed Jun 02 2021
Journal Name
International Journal Of Drug Delivery Technology
Mixed Ligand Complexes of Trimethoprim: A Review
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In this research, we highlight the most important research related to the mixed ligand complexes of the drug trimethoprim (TMP), and for the past 7 years where this drug has been used as a chelating ligand and gives stability to the complexes with ions of metal elements where these complexes, prepared and diagnosed, and for some research the bacterial activity was studied against different types of bacteria.

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Publication Date
Mon May 11 2020
Journal Name
Journal Of Arts, Literature, Humanities And Social Sciences
The Kite Runner; A Journey of Growth
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Publication Date
Fri Jun 25 2021
Journal Name
International Journal Of Drug Delivery Technology
Mixed Ligand Complexes of Trimethoprim: A Review
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In this research, we highlight the most important research related to the mixed ligand complexes of the drug trimethoprim (TMP), and for the past 7 years where this drug has been used as a chelating ligand and gives stability to the complexes with ions of metal elements where these complexes, prepared and diagnosed, and for some research the bacterial activity was studied against different types of bacteria

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Effect of Ochratoxin-A on Mouse Embryos
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This study sought to determine malformation caused by Ochratoxin-A (OTA) on mouse embryos. Twenty adult female white Swiss mice (mus msculus) were divided into four groups, with five females per group, and with one male placed with two females in a cage. Avaginal plug was observed in the early morning and the day of mating was considered as day of pregnancy followed by the first day of pregnancy. Three sub lethal concentrations of OTA were applied to the respective groups (other than the control), 1mg/kg, 2mg/kg and 4mg/kg. The animals were given 0.1 ml per 10 gm body weight per concentration of OTA once a day during days 7-14 of pregnancy. The control group animals were given distilled water. The pregnant mice were dissected, and the embry

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