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Biomedical subjects

B Johanson

Publications and source records attributed to B Johanson.

At least 19 recordsLinked to original sources
PubMed1987

Facial morphology and occlusion at the stage of early mixed dentition in cleft lip and palate patients treated with delayed closure of the hard palate.

Cephalometric radiographs and dental study casts were analyzed in a group of 23 seven-year-old cleft lip and palate patients, 16 with unilateral and 7 with bilateral cleft. The patients' primary surgical procedures had been completed except for closure of the cleft in the hard palate. For comparison, similar records from another group of patients, 18 with unilateral and 8 with bilateral cleft lip and palate, were studied. In these cases the cleft of the hard palate had been repaired in infancy, using a vomer flap procedure. The results indicated that midfacial growth and dental occlusion of the unilateral cleft sample was significantly better in patients whose closure of the hard palatal cleft had been delayed to the stage of mixed dentition than where repair had been performed with a vomer flap in infancy. No differences were found, however, between similar subgroups with bilateral cleft lip and palate.

Cephalometry↗
PubMed1987

Bone grafting at the stage of mixed dentition in cleft lip and palate patients.

Our results of bone grafting to the alveolar process during the mixed dentition were investigated in 55 consecutively treated patients (66 clefts). The amount of remaining bone and gingival retraction at the tooth mesial to the cleft after 3 and 12 months was measured and correlated with the following anatomical conditions present during surgery: width of the cleft, rotation of the adjacent incisor, stage of eruption of the tooth distal to the cleft. It was also considered if any deciduous lateral incisor or canine was extracted during surgery and if any flap dehiscence took place postoperatively. It was found that flap dehiscence resulted in significantly less bone at 3 months and at 1 year after surgery. Furthermore, extraction of a deciduous tooth was found to be significantly correlated to less bone 1 year after surgery, in which cases there were also persisting gingival retractions. The other factors had no significant influence on the outcome of surgery.

Alveolar Process↗
PubMed1986

Skull morphology after early craniotomy in patients with premature synostosis of the coronal suture.

The degree of normalization of the shape of the skull was studied in 12 craniosynostosis patients who had been treated with different types of craniotomies in infancy. Three diagnoses were represented: isolated bicoronal synostosis; Crouzon's syndrome; and Apert's syndrome; there were four subjects in each group. Selected cranial dimensions were measured on roentgencephalograms taken in infancy and at follow-up examinations at 2 to 3 years of age. The measurements were compared with control values obtained from patients with cleft lip. Cranial dimensions in the synostosis patients seldom corresponded well with the values of the controls, either before or after surgery. Cranial height, in particular, was increased, especially in patients with Crouzon's or Apert's syndrome. This resulted in modulus values above the control mean for 11 of the 12 patients at the follow-up examinations.

Acrocephalosyndactylia↗
PubMed1985

Cephalometric radiography and computed tomography in infants undergoing craniofacial surgery.

A program for preoperative workup and post-operative follow-up in children with craniofacial anomalies is described. Objective measurements were made with cephalometry and computed axial tomography. Improvement in length of the anterior cranial base and shape of the calvaria after surgery and growth was demonstrated in this manner in serial follow-ups. It was concluded that both cephalometry and computed tomography were essential for the diagnosis, surgical planning and follow-up for this group of patients.

Cephalometry↗
PubMed1984

Effect of post-surgical jaw-orthopaedic treatment in unilateral cleft lip and palate patients.

Reduction of the contraction of maxillary segments in newborn infants with unilateral cleft lip and palate by means of post-operative maxillary orthopaedic treatment was evaluated in 32 consecutive patients. Early surgery was performed in three stages and jaw-orthopaedic treatment with an acrylic plate was started one week after the first and again after the second operation. Between the first and second operation, between the second and third operation and during the period from the first operation to the age of three years there were no significant differences in changes of maxillary width dimensions between half of the children using the plates most frequently and the other half, with one exception. This difference was probably due to differences in initial values between the two groups of children. Thus, the influence on maxillary dimensions and dental occlusion of jaw-orthopaedic treatment, carried out according to our routines, was very limited. On the other hand, other treatment objectives might have been facilitated.

Alveolar Process↗
PubMed1983

Cephalometric radiography and computed tomography in infants undergoing major craniofacial surgery--a comparison.

Craniofacial growth after surgery in children is not completely understood. We have therefore formed a programme for pre- and postoperative studies with both roentgencephalometric- and computed tomographic investigations. This regimen results in overlapping information. Thus, an assessment of the advantages and disadvantages of the two methods was made and exemplified in four patients. In our experience both cephalometry and CT are essential for the diagnosis, surgical planning and follow-up of surgically treated children with craniofacial anomalies. To minimize the radiation doses and the diagnostic procedures which in these cases often includes general anesthesia, patients with isolated, asymmetrical conditions such as plagiocephaly, might be followed with CT only, since roentgencephalometry can not add much information.

Cephalometry↗
PubMed1983

Growth of the anterior cranial base after craniotomy in infants with premature synostosis of the coronal suture.

The effect of early craniotomy (age range: 1-6 months) on the growth of the cranial base was studied in 9 subjects with different types of premature synostosis affecting the coronal suture. In 5 of them the premature fusion involved only growth sites in the coronal suture growth complex, while the remaining 4 cases had a diagnosis of a craniofacial synostosis syndrome, such as Apert, Crouzon and Pfeiffer. In all but one of the patients, the craniotomy was not only extended down to the inferior orbital fissures but was also combined with the release of a free-floating fronto-supraorbital bone flap. Follow-up roentgencephalometry to ages ranging from 10 to 36 months indicated that the length and the growth of the anterior cranial base improved considerably after the craniotomy. However, complete normalization did not occur, especially in the subgroup with craniofacial synostosis syndromes. The mid-face of these patients also remained deficient in spite of the craniotomy.

Cephalometry↗
PubMed1982

Adolescent facial morphology of early bone-grafted cleft lip and palate patients.

A final evaluation of the effect of early bone grafting (EBG) on facial growth was carried out. The sample included 19 bilateral and 42 unilateral cleft lip and palate patients with an age range of 15-20 years, which meant on average 16 years after the EBG procedure. Roentgencephalometric data indicated maxillary retrognathia in both cleft categories and also deficient vertical descent of the maxilla, especially in the anterior part. In about 40% of the bilateral and 50% of the unilateral cleft patients, the mid-facial growth attenuation had reached such magnitude that surgical advancement of the maxilla was necessary. Analysis of plaster casts revealed that in every second cleft area the EBG operation had made it possible to achieve continuity in the dental arch without the need for prosthodontic replacement of teeth. Fusion of the suture between the (pre)maxilla and vomer was suggested as the reason for the typical mid-facial morphology seen in our patients with the most pronounced growth impairment.

Adolescent↗
PubMed1981

Treatment of premature sutural synostosis.

Premature sutural synostoses are currently being treated at the Craniofacial Center at the Department of Plastic Surgery, University of Göteborg. A leading principle has been to release tethered parts of the skull and the facial skeleton in order to let the expanding brain mould the skeletal parts to an acceptable position. This can be achieved within the first year of life. When operating in later stages, the skeletal parts are wired in a semi-static position by a single osteosynthesis, still allowing expansion by the growing brain.

Craniofacial Dysostosis↗
PubMed1980

Cleft lip and palate treatment with delayed closure of the hard palate. A preliminary report.

A new routine for the surgical treatment of cleft lip and palate patients is presented. Beside the regular lip-nose surgery it includes delayed closure of the cleft in the hard palate and soft palate closure without push-back technique. The effect on early facial growth was evaluated by comparing eight of these patients, three years of age, with a matched group where the hard and soft palate was closed primarily by vomer flap and velar push-back. The new treatment method resulted in significantly less teeth in crossbite occlusion due to a wider maxillary dental arch. As yet no serious disadvantages have been recorded.

Cleft Lip↗
PubMed1980

Lip-nose morphology and symmetry in unilateral celft lip and palate patients following a two-stage lip closure.

A new method was developed to evaluate more objectively the morphology of the soft tissue lip and nose after treatment of the unilateral cleft lip and palate deformity. Plaster casts of the mid-face of the patients were analysed by use of angular, linear and surface measurements. Thirty cases were studied 4--10 years after the primary surgery of the lip, performed in two stages ad modum Johanson. The results indicated a satisfactory though slightly short lip in the former cleft area. The alar base of the nose was at the same horizontal level on the cleft as the noncleft side. The cleft nostril, however, was significantly greater in surface area and the length of its long axis as well as its angulation, differed between the two sides.

Cleft Lip↗
PubMed1980

Hypospadias. A review of 299 cases operated 1957-69.

A review of 299 unselected primary cases of hypospadias of all types treated during the period 1957 to 1969 is presented. The same indications for operation and the same surgical principles were applied in all cases. The surgical treatment was performed in two stages: meatotomy or meatotomy combined with straightening in the first stage and urethral construction according to Denis Browne's method in the second stage. Complications occurred after the urethral construction in 11/289 cases (separation of the skin flaps in 5/289 and fistulas in 6/289). All 11 patients were reoperated with fully satisfactory results. The long-term results were followed up in a series of 220/299 cases. This series was used to study different problems affecting hypospadias. The mean age at the first operation was 8.5 years and the median age 4.4. The mean age at the latest control was 15.1 years and the median age 18.4. At the latest control no relapses with regard to curvature were observed during erection in the 151/220 cases in which straightening was performed. The meatus was adequate in all cases and the urinary flow, measured with a uroflowmeter, was normal.

Adolescent↗