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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 Aug 30 2023
Journal Name
Al-kindy College Medical Journal
‘Peacock tail’ Clipping Technique for a Giant Middle Cerebral Artery Aneurysm: A Technical Note
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Background: Giant middle cerebral artery (MCA) aneurysms are surgically challenging lesions. Because of the complexity and variability of these aneurysms, a customized surgical technique is often needed for each case. In this article, we present a modified clip reconstruction technique of a ruptured complex giant partially thrombosed middle cerebral artery aneurysm.

Case description: The aneurysm was exposed using the pterional approach. Following proximal control, the aneurysm sac was decompressed. Then, we applied permanent clips to reconstruct the aneurysm neck. The configuration of the aneurysm mandated a tailored clipping pattern to account for resi

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Publication Date
Wed Jun 09 2021
Journal Name
International Journal Of Environmental Science And Technology
Water quality index toward a reliable assessment for water supply uses: a novel approach
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Publication Date
Sun Jul 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Using a 3D Chaotic Dynamic System as a Random Key Generator for Image Steganography
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In today's digital era, the importance of securing information has reached critical levels. Steganography is one of the methods used for this purpose by hiding sensitive data within other files. This study introduces an approach utilizing a chaotic dynamic system as a random key generator, governing both the selection of hiding locations within an image and the amount of data concealed in each location. The security of the steganography approach is considerably improved by using this random procedure. A 3D dynamic system with nine parameters influencing its behavior was carefully chosen. For each parameter, suitable interval values were determined to guarantee the system's chaotic behavior. Analysis of chaotic performance is given using the

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Publication Date
Thu Feb 29 2024
Journal Name
International Journal Of Safety And Security Engineering
Urban Safety is a Tool for Containing Slums to Reach a Sustainable Urban Structure
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Many cities suffer from the large spread of slums, especially the cities of the Middle East. The purpose of the paper is to study the reality of informal housing in Al-Barrakia and the most important problems that it suffers from. The paper also seeks to study the presence or absence of a correlation between urban safety indicators and urban containment indicators as one of the methods of developing and planning cities. This can be achieved through sustainable urban management. The slums are a source of many urban problems that threaten the security and safety of the residents and represent a focus for the concentration of crimes and drugs. The paper seeks to answer the following question: How can urban safety be improved through urban cont

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
English Personal Pronouns as a Manipulation Strategy in Political Discourse: A Critical Discourse Analysis
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Manipulation is a discursive concept which plays a key role in political discourse by which politicians can impose some impact on their recipients through using linguistic features, most prominent of which are personal pronouns (Van Dijk, 1995). The aim of this study is to investigate how politicians utilize the personal pronouns, namely; We and I and their possessive forms as a tool of manipulating the audience's mind based on Van Dijk's  "ideological square" which shows positive-self representation and negative-other representation (Van Dijk,1998:p.69). To this end, American President Donald Trump's 2020 State of the Union speech was chosen to be the data of analysis. Only (8)

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Publication Date
Tue Jun 01 2021
Journal Name
Bulletin Of Electrical Engineering And Informatics
A new pseudorandom bits generator based on a 2D-chaotic system and diffusion property
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A remarkable correlation between chaotic systems and cryptography has been established with sensitivity to initial states, unpredictability, and complex behaviors. In one development, stages of a chaotic stream cipher are applied to a discrete chaotic dynamic system for the generation of pseudorandom bits. Some of these generators are based on 1D chaotic map and others on 2D ones. In the current study, a pseudorandom bit generator (PRBG) based on a new 2D chaotic logistic map is proposed that runs side-by-side and commences from random independent initial states. The structure of the proposed model consists of the three components of a mouse input device, the proposed 2D chaotic system, and an initial permutation (IP) table. Statist

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
A Theoretical Study of the Docking of Medicines with some Proteins
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A set of ten drug compounds containing an amino group in the structure were determined theoretically. The parameters were entered into a model to forecast the optimal values of practical (log P) medicinal molecules. The drugs were evaluated theoretically using different types of calculations which are AM1, PM3, and Hartree Fock at the basis set (HF/STO-3G). The Physico-chemical data like (entropy, total energy, Gibbs Free Energy,…etc were computed and played an important role in the predictions of the practical lipophilicity values. Besides, Eigenvalues named HOMO and LUMO were determined. Linearity was shown when correlated between the experimental data with the evaluated physical properties. The statistical analysis was used to analy

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
A study of the characterization of CdS/PMMA nanocomposite thin film
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Nanocomposites of polymer material based on CdS as filler
material and poly methyl methacrylate (PMMA) as host matrix have
been fabricated by chemical spray pyrolysis method on glass
substrate. CdS particles synthesized by co-precipitation route using
cadimium chloride and thioacetamide as starting materials and
ammonium hydroxide as precipitating agent. The structure is
examined by X-ray diffraction (XRD), the resultant film has
amorphous structure. The optical energy gap is found to be (4.5,
4.06) eV before and after CdS addition, respectively. Electrical
activation energy for CdS/PMMA has two regions with values of
0.079 and 0.433 eV.

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Frequency of HLA Antigens in a Sample of Iraqi Brucellosis Patients
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Fifty one patients with serologically confirmed brucellosis and 70 healthy controls were phenotyped for HLA-A, -B, -DR and -DQ antigens by using standard microlympho-cytotoxicity method, and lymphocytes defined by their CD markers (CD3, CD4, CD8 and CD19). The results revealed a significant (Pc = 0.001) increased frequency of HLA-DR8 (41.18 vs. 10.0%) in the patients . A significant increased percentage of CD8+ lymphocytes was also increased in the patients (25.15 vs. 22.0%; P = 0.006), while CD3+ lymphocytes were significantly decreased (75.1 vs. 79.4%; P = 0.02).

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Publication Date
Mon Oct 01 2018
Journal Name
Plant Archives
A comparative anatomical study of three types of gymnospermplantscycasrevoluta,thujaoreintalisand cupressussemperviens
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