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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
Thu Jan 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Homomorphism of Cubic bipolar ideals of a KU-semigroup
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The idea of a homomorphism of a cubic set of a KU-semigroup is studied and the concept of the product between two cubic sets is defined. And then, a new cubic bipolar fuzzy set in this structure is discussed, and some important results are achieved. Also, the product of cubic subsets is discussed and some theorems are proved.

Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Historical Value of Dickens’s A Tale of Two Cities
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In "historical" fiction, characters that never really existed, give expression to the impact of historical events on the people who really did live through them. The result is not history, as an accurate record of actual events, but fiction in which an earlier age is rendered through the personal joys and sufferings of characters. This paper
aims at investigating the historical realities presented in Dickens’s A Tale of Two Cities.

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
A THEORETICAL VISION OF THE METHODOLOGY OF MATCHING AND CONGRUENCE
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Perhaps the issue of media and the press, especially one of the most common topics that people deliberate and deal with permanently and continuously. An issue of such significance has pushed researchers to put the following question, “Is it possible to live without media?”, “Can people ignore the newspaper, radio, TV, or the other communication means?”

The answer is very simple. It is difficult for civilized society to overtake information, or dispense with circulation, at the individual or collective level. Yet, the question of how to make the media and how it determines its content still requires extensive media experience; and knowledge of the social structure and its relations; and ac

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Crossref
Publication Date
Fri Jun 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
A Stylistic Study of English Aphorisms of “Life and Death”
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In this paper , some of lexical stylistic , syntactical stylistic  devices , and one phonetic stylistic device are going to be illustrated in the study of the aphorisms of “life and death” . These stylistic  devices are parallelism , hyperbole , alliteration , meiosis , irony , oxymoron , cliché , litotes , metalepsis , and loose sentences.  This paper aims at identifying the functions and the  frequencies of these devices. These stylistic devices make one speech and writing more interesting and help to get the attention of readers/ listeners

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Planning a Medical Lecture
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The aims of the lecture should be clearly defmed. These will help to define the teaching methods and the structure. If, for example, the purpose of the lecture is to introduce new knowledge and concepts, then a classic lecture structure might be most appropriate. On the other hand, if the purpose is to make the students aware of different approaches to a particular clinical problem, a problem oriented design in which alternative approaches are presented and discussed might be a more appropriate fonnat.
Lectures are still a common teaching methOd in both undergraduate and postgraduak medical education. Properly done, the lectwe is a creative and personal work by the teachll:l modeled upon his intellectual scaffolding. Few other fonns o

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Publication Date
Thu Dec 01 2022
Journal Name
Scientific Research Journal Of Engineering And Computer Science
Cryptography Techniques - A Review
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Publication Date
Thu Sep 15 2022
Journal Name
Al-adab Journal
Towards a Humanitarian Race
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Crossref
Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
A ruling Zakat ornaments
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The research topics important topic of jurisprudence worship, a ruling Zakat ornaments
prepared for use, and touched the odds scholars in it. Stroll scholars say that there is no Zakat
on ornaments prepared for use have reported their evidence they and the owners say the other
of those who say should be directed to pay zakaat, and discuss those views and statement
Dafeeha of Sahihaa, and came up with a summary then, showed where the prevailing view
that I see in agreement of the transferee and reasonable. Ask Him to show us the right, and
thank God.

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Publication Date
Mon Jul 18 2022
Journal Name
World Bulletin Of Public Health (wbph)
WASTEWATER TREATMENTS: A REVIEW
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Many water supplies are now contaminated by anthropogenic sources such as domestic and agricultural waste, as well as manufacturing activities, the public's concern about the environmental effects of wastewater contamination has grown. Several traditional wastewater treatment methods, such as chemical coagulation, adsorption, and activated sludge, have been used to eliminate pollution; however, there are several drawbacks, most notably high operating costs, because of its low operating and repair costs, the usage of aerobic waste water treatment as a reductive medium is gaining popularity. Furthermore, it is simple to produce and has a high efficacy and potential to degrade pollu

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
A consensus on measurement
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Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus

Building a blind measuring guide.
 We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.

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