Abstract
PurposeThe aim of this retrospective study was to evaluate facial growth in children with juvenile idiopathic arthritis (JIA) by means of lateral head cephalometric radiographs and relate the findings to temporomandibular joint (TMJ) condylar changes on panoramic radiographs.MethodsRadiographic and medical records were evaluated in 65 children with JIA. Cephalometric and panoramic analyses were performed for the impact of condylar changes on facial growth. We compared children with condylar alterations, minor or major, with those without condylar alterations.ResultsBased on panoramic radiographs, no condylar alterations were seen in 27 of the 65 children and condylar alterations were seen in 38 children (i.e., 23 had minor and 15 major condylar alterations). The cephalometric analyses of the children with condylar changes showed significant growth disturbances with a more retrognathic mandible (SNB; p = 0.03), retruded chin position (SNPog; p = 0.02), larger mandibular angulation (ML/NSL; p = 0.009) and maxillary angulation (NL/NSL; p = 0.03) compared with children without condylar alterations. Children with minor condylar alterations had a significantly more retruded chin position (SNPog) than those with no condylar changes (p = 0.04).ConclusionsCondylar changes in the TMJ, judged on panoramic radiography, in children with JIA, have impact on craniofacial growth. Even minor alterations seem to have an impact.
Highlights
Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease in which one or more joints, including the temporomandibular joint (TMJ), can be involved
U/L FH (%) shows the relationship between two distances representing upper and lower facial height standard deviations (SD) standard deviation, AUC area under the curve, 95% CI 95% confidence interval performed using SPSS version 23 (SPSS Inc., Chicago, IL, USA)
We found no statistical difference between participants with or without condylar alterations regarding disease duration but children with major condylar alterations (n = 15) did have longer disease duration (p = 0.03) compared with children with no condylar alterations (n = 27)(data not shown)
Summary
Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease in which one or more joints, including the temporomandibular joint (TMJ), can be involved. It is the most common rheumatic disease of childhood, with an onset before the age of 16. In 1995, the International League Against Rheumatism (ILAR) classification, based on the number of active joints, clinical and laboratory features, as well as heredity, was proposed and it is currently used worldwide [22]. The TMJ may be the only joint involved and TMJ arthritis can be active with or without any symptoms [2]. The radiological methods used and the populations studied have varied between previous studies
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