Abstract
ObjectiveTo investigate the relationship between radiographic JIA disease course in the TMJs and mandibular growth rotation, compared with growth in healthy individuals.MethodsFrom a larger series of JIA patients followed from childhood to adulthood, 26 were included; 11 without and 15 with bilateral radiographic TMJ involvement. Joint morphology and function were assessed at baseline, 2-, 4-, 6- and 27 years follow-up. Mandibular growth rotation (anterior, posterior or none) was assessed from cephalometric evaluations at childhood and adulthood, with observations from 16 healthy individuals as controls. TMJ disease course and mandibular growth rotation were assessed independently and their relationship analysed. Non-parametric statistical methods were applied to test differences between groups.ResultsIn the normal TMJ group of JIA patients the joint morphology was similar at the follow-ups and all patients had good function both in childhood and in adulthood. The mandibular growth rotation was similar to that of healthy controls, i.e. predominantly in anterior direction. In the abnormal TMJ group different JIA TMJ disease courses were observed and associated with changes in the mandibular growth rotation (p = 0.007).Progressing JIA TMJ disease course was related to posterior mandibular growth rotation and improving disease course to anterior mandibular growth rotation.ConclusionA relationship was found between JIA disease course in the TMJs and mandibular growth rotation, suggesting that a favourable growth could be regained in patients with improvement in TMJ morphology and/or TMJ function. To confirm this, further research on larger patient series is needed.
Highlights
A relationship was found between Juvenile idiopathic arthritis (JIA) disease course in the temporomandibular joint (TMJ) and mandibular growth rotation, suggesting that a favourable growth could be regained in patients with improvement in TMJ morphology and/or TMJ function
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions including seven subtypes according to the ILAR (International League of Associations for Rheumatology) classification [1]
The presence or absence of JIA TMJ abnormalities was judged by diagnostic imaging, including computed tomography (CT) and magnetic resonance imaging (MRI) at the final follow-up
Summary
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions including seven subtypes according to the ILAR (International League of Associations for Rheumatology) classification [1]. The temporomandibular joint (TMJ) is frequently affected in JIA, leading to disturbed mandibular function. Ties, following patients from childhood to adulthood, seem to be lacking. From a group of 103 patients with JIA examined as children [6,23], a follow-up examination of 60 patients as adults was carried out without selection for TMJ and craniofacial findings in childhood [24]. Normal facial profile was found, the majority of the adult patients with TMJ involvement showed a smaller, more retrognathic mandible and a steeper mandibular plane than healthy controls [5]. The differences in craniofacial morphology between the patients and the controls increased with older age [25]. The frequency of radiographic TMJ involvement increased significantly from childhood to adulthood [24]. The development and progression of radiographic TMJ abnormalities was a dominating feature, an evident improvement of radiographic TMJ abnormalities occurred
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