Condylar alterations and facial growth in children with juvenile idiopathic arthritis

Abstract

The 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. Methods Radiographic 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. Results Based 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). Conclusions Condylar 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.

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

“…We would argue that this condylar flattening might represent normal variations, as previously shown in several studies [38][39][40]. In their recent study of panoramic radiographs of 65 children (mean age 12 years old), Cedströmer and colleagues pointed out that even minor bony deformities might hamper craniofacial development [41]. However, our study shows that there is a significant difference between the oligoarticular and polyarticular subtypes.…”

Arthritis and dentistry

“…Radiographic changes to the TMJ that may be seen include changes to the shape and structure of the TMJ such as sclerosis, erosions, flattening of the condyle head, and osteophytes. 14 Condylar hypoplasia can occur resulting in restricted mandibular growth leading to development of mandibular retrognathism. 15 As a result these patients commonly present with a skeletal II malocclusion and anterior open bite.…”

Role of Ultrasound Evaluation of Temporomandibular Joint in Juvenile Idiopathic Arthritis: A Systematic Review

“…In JIA patients, the term dentofacial deformity refers to the alteration in facial bone growth, development, and structure due to TMJ arthritis [ 12 ]. Micrognathia, retrognathia, and frontal facial asymmetry are the most frequently reported dentofacial deformities in JIA patients, as well as the deviation of the mandible on maximal mouth opening [ 13 , 14 , 15 , 16 ].…”