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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 Jun 30 2022
Journal Name
International Journal Of Drug Delivery Technology
Expression of Vascular Endothelial Growth Factor in the Placenta of Iraqi Women Complicated with Hypertensive Disorder
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During pregnancy, high blood pressure disorder is the most common medical complication in pregnancy. It is the foremost cause of maternal mortality and perinatal diseases. Vascular endothelial growth factor (VEGF) affects the growth of vascular endothelial cells, existence, and multiplying, which are known to be expressed in the human placenta. This study aimed to identify the expression VEGF in the placenta of hypertension and normotensive women. In this study, a cross-sectional study from november 2019 to February 2020. A total of 100 placentae involved 50 hypertensive cases and 50 normotensive groups were assessed. VEGF-A expression in two placentas groups was evaluated by immunohistochemistry techniques. Strong and moderate VEGF

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Phylogenetic Tree Analysis of First Psychrobacter Sp. Strain From Blood of Iraqi Patient; A Case Report
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Publication Date
Sat Apr 06 2024
Journal Name
Al- Anbar Medical Journal
Metastatic Ovarian Tumor from Incidental Renal Cell Carcinoma: A Case Report and Literature Review
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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Post-Traumatic Stress Disorder among Women with Breast Cancer in Iraq: A Preliminary Report
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Publication Date
Fri Jun 26 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Sagittal Condylar Position of TMJ Dysfunction in Centric Occlusion by Using Cone Beam Computed Tomography
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Background: Temporomandibular joint (TMJ) is a compound articulation formed from the articular surfaces of the temporal bone and the mandibular condyle.CBCT imaging of TMJ is that it allows accurate measurements of the volume and surface of the condyle. The aim of the study is to assess the sagittal position of mandibular condyle in patients with temporomandibulardysfunction using Cone Beam Computed Tomography in centric occlusion. Materials and Methods: CBCT images for all patients were obtained in an upright position using New Tom Giano CBCT with different field of view (11 x 8), (11 x 5), and (8 x 8) and exposure factors was changed accordingly using NNT version 5.1 software for sagittal reconstruction, anterior, superior and posterior

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Publication Date
Sun Aug 25 2024
Journal Name
Cardiometry
Evaluations of Bone turnover in a sample of Iraqi Postmenopausal Hypertensive Obese Women
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Background: Hypertension and osteoporosis are worldwide diseases with high prevalence; the study was done to estimate the correlation between hypertension and bone turnover in a sample of Iraqi postmenopausal women with hypertension and obesity. Materials and Methods: A cross-sectional study was done on 99 hypertensive obese postmenopausal Iraqi women (65 hypertensive obese and 34 normotensive non obese). The serum calcium (Ca), phosphorus (Pi), and alka line phosphatase (ALP) levels were measured as a represen tative of bone markers. Results: The results demonstrated that serum alkaline phosphatase is significantly elevated in the case group compared to the controls. No significant changes were observed in the levels of Ca and

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of The Medicine Baghdad
Do low back pain changes correlate with sagittal lumbar alignment changes after total hip replacement arthroplasty?
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Abstract Background: The hip joint and lumbar spine are both anatomically and functionally closely related as had shown by many authors. So the abnormality in one area can affect the other e.g. hip joint osteoarthritis can cause lumbar sagittal malalignment and backache. Objectives: is to see if there is significant improvement in backache after total hip replacement? And which degree of backache improvement is associated with significant changes in lumbar lordosis? Methods and patients: a prospective open trial study was performed on 30 patients who had severe hip osteoarthritis and chronic low back pain. Total hip replacement was performed to all patients. Backache and lumbar lordosis were measured by visual analogue scale and Cobb’s a

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Publication Date
Sun Jan 02 2022
Journal Name
Neuroquantology
Treatment of primary trigeminal neuralgia: A comparative study of microvascular decompression surgery and stereotactic gamma knife radiosurgery
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Objectives To compare the clinical efficacy of microvascular decompression surgery (MVD) and gamma knife radiosurgery (GKR) as a treatment for patients with primary trigeminal neuralgia (TN) and evaluate the outcome regarding pain relief, recurrence, and complications with both modalities of treatment. Patients and Methods A randomized prospective study conducted in SaadAlwitry Neurosciences Hospital, Baghdad, Iraq. Eighty-four patients with TN from January 2016 to January 2018, 45 patients had GKR while 39 patients treated with MVD. The pain evaluated pre-and post-operatively using the Barrow Neurological Institute Pain Intensity scale (BNIPI), visual analog scale (VAS) and Brief Pain Inventory Facial (BPI-Facial) scoring systems. In GKR p

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Nonlinear Analysis And Applications
A general solution of some linear partial differential equations via two integral transforms
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In this paper, a new analytical method is introduced to find the general solution of linear partial differential equations. In this method, each Laplace transform (LT) and Sumudu transform (ST) is used independently along with canonical coordinates. The strength of this method is that it is easy to implement and does not require initial conditions.

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering
Reuse of Glass waste as a partial replacement to fine aggregates in concrete
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As human societies grow, the problem of waste management becomes one of the pressing issues that need to be addressed. Recycling and reuse of waste are effective waste management measures that prevent pollution and conserve natural resources. In this study, the possibility of using glass waste as an alternative was used as a partial weight substitute for fine aggregates with replacement ratios of 10, 20, 30, and 40% by the weight, and formed into test models (15 cm * 15 cm ) cube and (15 cm * 30 cm) cylinder, then matured and tested their strength compression and tensile strength at the age of 7 and 28 days and compared with a reference or conventional concrete with a mixing ratio (1: 1.5: 3) as well as testing its worka

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