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Biomedical subjects

B Rune

Publications and source records attributed to B Rune.

At least 19 recordsLinked to original sources
PubMed2001

Displacement of the mandible in a child with congenital unilateral temporomandibular joint ankylosis treated with two-stage condylar replacement: a long-term study with the aid of roentgen stereometric analysis.

OBJECTIVE: To monitor mandibular displacement in three dimensions with a high degree of accuracy before, during, and after treatment. DESIGN: Prospective roentgen stereometric analysis from age 3 years 7 months to age 13 years 8 months. SETTING: Center for Craniofacial Anomalies and Department of Maxillofacial Surgery, Malmö University Hospital, Malmö, Sweden. PATIENT: Girl with unilateral congenital temporomandibular joint (TMJ) ankylosis and marked facial asymmetry. INTERVENTIONS: Epipharyngeal inspection at age 2 years 6 months and insertion of implants under general anesthesia. Resection of the affected right condyle at age 5 years 4 months, replacement of the ramus-condyle complex with a custom made titanium prosthesis at age 5 years 5 months, and replacement of the artificial condyle by a costochondral graft at age 9 years 7 months. Roentgen examinations were performed at intervals from age 3 years 7 months to age 13 years 8 months. Body length was measured annually. MAIN OUTCOME MEASURES: Stereo roentgenograms were digitized by the Department of Orthopedic Surgery, Malmö University Hospital. RESULTS: Unexpected lowering of the mandible occurred before treatment. Each procedure had a distinct effect on the direction of mandibular displacement. There was little or no pathological involvement of the functional matrix. Growth of the costochondral graft exceeded growth of the unaffected TMJ. Anterior displacement as well as rotation and tilting of the mandible to the unaffected side accelerated after the age of body peak height velocity. CONCLUSIONS: Accurate monitoring of mandibular displacement may contribute to a rationale for clinicians' decision on treatment protocol and reveal compensatory differential growth.

Adolescent↗
PubMed2000

Facial growth in a cleft palate patient treated with the Herbst appliance: a long-term profile roentgenographic and roentgen stereometric analysis of profile changes and displacement of the jaws.

OBJECTIVE: To monitor facial development in a patient with cleft palate who was treated with the Herbst appliance. Monitoring was in terms of changes in the skeletal profile and growth in the circummaxillary sutures and temporomandibular joints (TMJs). DESIGN: Prospective profile roentgenography (between the ages of 6 and 20 years) and roentgen stereometric analysis (between the ages of 8 and 19 years). SETTING: Center for Craniofacial Anomalies and Department of Plastic and Reconstructive Surgery, Malmö University Hospital, Malmö, Sweden. PATIENT: Boy with cleft of the soft and posterior part of the hard palate and marked facial convexity. INTERVENTIONS: Surgical repair of the soft palate at age 9 months, velopharyngeal flap at age 8 years, and insertion of implants under general anesthesia and treatment with the Herbst appliance at age 11 years. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. MAIN OUTCOME MEASURES: Profile roentgenograms were traced and measured by one of the authors using conventional point-based analysis. Stereo roentgenograms were digitized by the Department of Orthopedic Surgery, Malmö University Hospital. RESULTS: The direction of profile changes was partly discordant with the direction of articular growth in the circummaxillary sutures and TMJs. The successful treatment result was accomplished by a temporary influence on sagittal growth direction in the circummaxillary sutures and on rotational growth direction in the TMJs, combined with a favorable natural remodeling and articular growth pattern. CONCLUSIONS: The mode of growth by which treatment aims were reached was partly unexpected, i.e., discordant with the generally accepted principal concept that treatment with the Herbst appliance positions the mandible forward.

Adolescent↗
PubMed1999

Mandibulofacial dysostosis--variability in facial morphology and growth: a long-term profile roentgenographic and roentgen stereometric analysis of three patients.

OBJECTIVE: To monitor and compare facial morphology and growth in three individuals with variable expression of mandibulofacial dysostosis (MFD) in terms of changes in the skeletal profile and in terms of growth in the circummaxillary sutures and temporomandibular joints (TMJs). DESIGN: Retrospective conventional profile roentgenography (mean age 9 to 18 years) and prospective roentgen stereometric analysis (RSA) (mean age 7 to 17 years). SETTING: Center for Craniofacial Anomalies and Department of Plastic and Reconstructive Surgery, Malmö University Hospital, Sweden. PATIENTS: The first three MFD patients seen by one of the authors (B.R.). INTERVENTIONS: Surgery was performed at the Department of Plastic and Reconstructive Surgery. Implants were inserted at surgery under general anesthesia. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. MAIN OUTCOME MEASURES: All profile roentgenograms were traced and measured by one of the authors (K.-V.S.) using a conventional point-based analysis. RESULTS: The more afflicted patient showed a greater total difference in profile morphology and growth from the norm and more pronounced effects of articular growth restriction. Little change in the skeletal profile was associated with considerable displacement of the jaws. CONCLUSIONS: The variability in MFD expression and surgical procedures in our patients is reflected less in the skeletal profile morphology and growth and more in the displacement of the jaws.

Adolescent↗
PubMed1998

Bone grafts to the nose in Binder's syndrome (maxillonasal dysplasia): a follow-up of eleven patients with the use of profile roentgenograms.

Bone grafts are used to lengthen the dorsum and elevate the tip of the nose in patients with Binder's syndrome. Disappointing long-term results in some patients generally have been assumed to be a result of resorption and/or displacement of the grafts. Treatment outcome was studied in 11 patients with the use of serial profile roentgenograms. At 40 months, the mean values after surgery were reduction of the initial transplant length by 28 percent and reduction of the transplant angle by 4 degrees. The initial nose length was increased by 1 mm, and nose tip projection was increased by 2 mm. Although the mean changes of nose length and nose tip projection seemed small, treatment outcome varied considerably between patients. In contrast with earlier assumptions, no correlation could be found between the degree of transplant resorption and/or displacement and the effect of surgery on nose length and nose tip projection.

Adolescent↗
PubMed1995

Intramatrix rotation--the frontal bone.

Intramatrix rotation during growth and development was studied by 2-D cephalometric technique with the use of metallic implants in the frontal bone in five patients at the Centre for Craniofacial Anomalies, Malmö General Hospital. The analysis of the frontal bone in the five patients showed rotations of the corpus inside the periosteal matrix from 1 to 9.5 degrees in the mid-sagittal plane. The essential conclusion of these observations is that an intramatrix rotation takes place during the development of the frontal bone. This observation will stimulate further studies of its nature, amount, and direction.

Adolescent↗
PubMed1992

Long-term effect of rapid maxillary expansion studied in one patient with the aid of metallic implants and roentgen stereometry.

The articulatory displacement of maxillary bones during and after rapid maxillary expansion (RME) was studied with metallic implants and roentgen stereometry (RSA) for 3653 days in a girl aged 12 at start of treatment. She had a narrow upper dental arch with anterior crowding and a normal incisor relationship, and a normal sagittal molar relationship with bilateral cross-bite. Three implants were inserted in each maxillary bone and they remained stable in the bones during the 10-year observation period. In the 3-D analysis of the articulatory displacement, the left maxillary bone was studied in relation to the right bone in three periods: RME (23 days), retention (108 days) and follow-up (3522 days). Extensive relapse of rotations as well as translations was found and the long-term effect of RME was limited. In our opinion the relapse was caused mainly by the resistance to deformation from circum-maxillary sutures and surrounding soft tissue matrix, and inadequate bone formation in the involved sutures. As is generally known in clinical oral orthopaedics, changes obtained by short-term simple mechanical interference with a complex biological system tend to reverse spontaneously. Thus, the rationale for RME treatment may be seriously questioned.

Biomechanical Phenomena↗
PubMed1989

[The effect of passive plates on the arrangement of the alveolar arch segments in unilateral total cheilognathopalatoschisis].

Maxillary alveolar arch morphology was studied from birth to palate repair at the age of 19 months in 24 children with complete unilateral cleft lip and palate (UCLP) treated with passive orthopaedic plates (treated children). 18 children with the same defect, who received no orthopaedic treatment, served as controls. The surgical procedures and the age at lip and palate repair were similar. Maxillary alveolar arch morphology was described by 15 linear and five angular measurements. No significant difference was found in total alveolar crest length neither between the cleft and the non-cleft maxillae nor between the treated children and the controls. Anterior alveolar arch width was significantly larger in the treated children at lip repair and at palate repair. Posterior alveolar arch width was significantly larger in the treated children at lip repair only. There was no significant difference in alveolar cleft width between the treated children and the controls at lip or at palate repair. Palatal cleft width decreased significantly in the treated children only. Medial rotation of both the cleft and the non-cleft maxillae was observed in both groups. The main difference was the absence of arch collapse in the treated children. At palate repair the relationship between the two maxillae was more favourable in the treated children for the development of the occlusion. The occlusion of the mixed dentition will be subject of a subsequent follow-up.

Cleft Lip↗
PubMed1989

Dental replacement resorption after bone grafting to the alveolar cleft.

In a review of 100 consecutively performed bone grafts to the alveolar cleft, replacement resorption was found in 7 teeth adjacent to the cleft. Damage to the periodontal tissues during surgery is considered to be the main cause of this complication: granulation tissue from the bone graft may have some influence. Treatment of the affected teeth eventually includes extraction or surgical removal. To minimize the risk for this complication, we suggest that bone grafting should be done when the canine (or lateral incisor) is in an early stage of eruption and that orthodontic uprighting of the medial incisor should be done after surgery.

Adolescent↗
PubMed1989

Changes of the profile after advancement genioplasty.

Surgical advancement of the chin, and postoperative relapse, were studied during a three-year period in 17 patients. Changes were measured on lateral cephalograms obtained at certain intervals. Sagittal skeletal changes were recorded parallel to the Frankfort Horizontal plane. Soft tissue changes were recorded by advancement of soft tissue Pogonion along a line parallel to the mandibular base line and by the increase of the angle NFL/NCL. The average skeletal advancement was 8 mm with a relapse of 1 mm two months after surgery. No further changes were registered during a three-year observation period. The average soft tissue advancement was 7.5 mm from two months after surgery and no relapse was found after this time. The soft to hard tissue ratio of the changes was 0.94 which corresponds to results reported in the literature. There was no correlation between the average amount of advancement and the amount of relapse. The range of changes showed a wide variation, however.

Adolescent↗
PubMed1988

Changes in mandibular position during treatment with disk-repositioning onlays: a roentgen stereophotogrammetric study.

Seven patients with temporomandibular joint disk displacement were treated with disk-repositioning onlays, and changes in the mandibular position were studied by means of roentgen stereophotogrammetry. A wide range of changes in mandibular position was seen at cementation of the onlays and during the observation period. On an average, recapturing of the disk and cementation of the onlays lowered the mandible by 2.5 mm and protruded it by 0.5 mm. During the observation period of 7 months the mandible had a tendency to resume its original position. The relapse was 80% in the sagittal plane, 70% in the transverse plane, and 12% in the vertical plane. It was concluded that disk-repositioning onlays can be used to lower the mandible with a relatively small relapse. Changes in the horizontal plane, however, seem to be less stable.

Adolescent↗
PubMed1988

Accuracy of the oblique lateral transcranial projection, lateral tomography, and x-ray stereometry in evaluation of mandibular condyle displacement.

Condylar displacement similar to that occurring during and after mandibular ramus osteotomies was simulated in an in vitro study. Three different radiographic methods were used to measure the displacement, and the accuracy of the methods was compared. The stereometric method was more accurate than the plain radiographic methods and permitted measurements in all three dimensions. The oblique lateral transcranial projection was more accurate than lateral tomography, possibly because identification of measurement points in lateral tomography was complicated by the substantial displacement of the condyle.

Craniotomy↗
PubMed1988

Condylar displacement after oblique sliding osteotomy of the mandibular rami. A stereometric and plain radiographic study.

Condylar displacement after oblique sliding osteotomy was examined in 8 patients by X-ray stereometry and plain radiography. During the first 8 postoperative weeks the displacement was in a medial/superior/posterior direction. After removal of the intermaxillary fixation a continuous lateral translation was found together with an initial inferior and a minor anterior translation which after 6 months postoperatively changed to a posterior translation. At 12 months postoperatively a difference in findings of condylar position was found between the X-ray stereometric and plain radiographic analyses. We regard this difference as due to the sum of remodelling and method errors.

Adult↗
PubMed1987

Stability of the osteotomy site after oblique sliding osteotomy of the mandibular rami. A stereometric and plain radiographic study.

Displacement of the mandible 2-2 1/2 years after oblique sliding osteotomy of the mandibular rami is reported. Stability of the osteotomy site has been assumed to be complete much earlier, however. In the present stereo radiographic study mobility at the osteotomy site was recorded as late as 2 years after surgery. No sign of delayed healing was recorded in the plain radiographic examination. It seems possible that relapse after oblique sliding osteotomy continues as long as the functional matrix can influence an unstable osteotomy site. As plain radiography does not give full information on the quality of bone, the stability of the osteotomy site can not be assessed by this method.

Adolescent↗
PubMed1987

Extraoral traction to the maxilla with face mask: a follow-up of 17 consecutively treated patients with and without cleft lip and palate.

Lateral cephalometric films of seven cleft palate (CP) or unilateral cleft lip and palate (UCLP) and ten nonCLP patients were obtained immediately before extraoral traction with face mask, immediately after, and at 6 months follow-up. The mean age at start of treatment was 7 years for the CLP patients and 11 years for the nonCLP patients. The average duration of traction was 8 months in both groups. The traction force was gradually increased from 300 to 800 g on each side. Five angular measurements were defined and recorded. The mean net effect in anterior displacement of the maxilla in the CLP group was +0.2 degrees (range +2.5 degrees to -2.5 degrees) and in the nonCLP group +1.0 degree (range +2.5 degrees to -1.0 degree). The orthopaedic effect of extraoral traction to the maxilla was found to be independent of skeletal morphology, age, peak height velocity (PHV), and duration of traction, and thus to be unpredictable. Normal overjet was obtained in most patients, because of a combination of anterior displacement of the maxilla, posterior displacement of the mandible, tipping of the incisors, and a possible anterior sliding of the maxillary dental arch on its base.

Adolescent↗