Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement

Hsieh, Yun-Huan; Darvann, Tron A.; Hermann, Nuno V.; Larsen, Per; Liao, Yu‐Fang; Bjoern-Joergensen, J.; Kreiborg, Sven

doi:10.1016/j.ajodo.2015.07.033

Cited by 29 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, characteristics of posterior rotated and retrognathic mandible analyzed on lateral cephalometric radiographs could to some extent already be seen in children with minor condylar alterations, but, most of all, condylar alterations seemed to be important risk factors for impaired facial growth. These observations are in line with a 2016 report by Hsieh et al, who also using a grading system for severity of radiological changes [12], as well as a recent report using three-dimensional assess-K Fig. 5 Panoramic radiograph in a healthy teenage girl showing normal condylar heads and normal bite Abb.…”

Section: Discussionsupporting

confidence: 89%

Condylar alterations and facial growth in children with juvenile idiopathic arthritis

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 89%

Condylar alterations and facial growth in children with juvenile idiopathic arthritis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Limited reports exist on the relationship between 3D facial photographs of JIA patients and presumed uni-or bilateral TMJ involvement established on cephalograms [14] or panoramic films [29,30]. As outlined in the introduction, scientific literature has produced ample and rich evidence that these two-dimensional radiographs fail to reflect TMJ lesions and their extent reliably [7].…”

Section: Discussionmentioning

confidence: 99%

“…As arthritis of the TMJ is frequently asymptomatic, a dependable facial examination could serve an important purpose to disclose possible craniofacial growth deficiency and to establish a timely interventional strategy [13]. With the introduction of three-dimensional (3D) photography as documentation method for facial morphology [14], it is assumed that the diagnostic value of facial assessment to detect TMJ involvement can be increased. Indeed, the advocated advantages of an evaluation of the face by means of stereophotogrammetry include not only an improved reproducibility, high spatial resolution, and no ionizing radiation, but also the possibility to conduct quantitative analyses from morphometric measurements.…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of facial asymmetry based on three-dimensional photography: a valuable indicator for asymmetrical temporomandibular joint affection in juvenile idiopathic arthritis patients?

et al. 2020

View full text Add to dashboard Cite

Background: Juvenile idiopathic arthritis (JIA) can cause osseous deformity in the temporomandibular joint (TMJ) and may impair mandibular growth. This study aimed to evaluate whether facial asymmetry determined clinically or by morphometric analysis of three-dimensional (3D) photographs in JIA patients is associated with an asymmetric affection of theTMJ.Methods: Of 76 consecutive JIA patients with a mean age of 11.7 years (range: 6.3-17.9), facial asymmetry was evaluated clinically (chin asymmetry, gonion asymmetry), and stereophotogrammetrically with 3D photographs. The facial surfaces were demarcated, then mirrored, superimposed using semi-automated landmarks, and quantitatively assessed (chin asymmetry, Hausdorff distances). Clinical and digital measurements were related to the diagnosis of right and left TMJ involvement derived from magnetic resonance images (MRI). Results: Twenty-seven (34%) patients had an asymmetrical osseous deformity of the TMJ. By clinical evaluation, chin asymmetry was related to asymmetrical osseous destruction (p = 0.02), but gonion asymmetry was not (p = 0.14). In regard to 3D-photograph based morphometric measurements, chin asymmetry was also related to asymmetrical osseous destruction (p = 0.01), but neither the mean (p = 0.06) nor the maximal Hausdorff distance (p = 0.67). Despite the attested significance, none of the chin asymmetry evaluation methods appeared to hold sufficient predictive value (positive predictive values ≤54%; coefficient of determination ≤7%). Conclusions: For the assessment of facial asymmetry in JIA patients, morphometric measurements originating from 3D-photographs seem to deliver results comparable to the clinical assessment methods. The asymmetry of the face, especially around the chin, appears to be related to asymmetrical TMJ destruction, but none of the investigated measurement methods of the face were able to reliably predict the TMJ affection. Thus, facial asymmetry assessments, both qualitatively in a clinical setting and quantitatively based on 3D-photographs, have limited diagnostic value for TMJ involvement in JIA patients.

show abstract

“…JIA should be a disease of special dental interest: The temporomandibular joint (TMJ) is involved in 40% to 93.33% of patients suffering from JIA [3]. The inflammation can lead to growth disturbances and thereby to severe orthodontic findings as mandibular micro-and retrognathia, anterior open bites and asymmetries [4,5]. In the majority of cases the involvement of TMJ is painless and therefore lately diagnosed [6].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis—A Cross-Sectional Study

Merle

Hoffmann²,

Schmickler

et al. 2020

JCM

View full text Add to dashboard Cite

Background: The aim of this cross-sectional study was to investigate oral health and functional status of adolescents with juvenile idiopathic arthritis (JIA) and its possible link to disease specific parameters. Methods: Patients with JIA were recruited (November 2012–October 2014) and disease specific information was extracted from patients’ records. Oral examination included: dental findings (decayed-, missing- and filled-teeth-index (dmf-t/DMF-T)), gingival inflammation (papilla-bleeding-index (PBI)) and periodontal screening index (PSI). Functional examination followed Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Additionally, modified Helkimo’s Clinical Dysfunction Index and radiographic scoring were recorded. Results: 59 JIA patients were included. The mean dmf-t/DMF-T was 2.6. Only one patient showed no signs of gingival inflammation, while 57.6% had a maximum PSI of 2 or less. Positive functional findings were assessed clinically in more than half of the patients. Major diagnosis by RDC/TMD was osteoarthrosis. Patients with at least one positive anamnestic or clinical functional finding revealed significantly higher radiographic scores (CI = 0.440, p = 0.022). Patients with increased c-reactive-protein had a significantly higher PBI (Z = –2.118, p = 0.034) and increased radiographic scores (CI = 0.408, p = 0.043). Conclusions: Adolescents suffering from JIA show high levels of caries experience and gingival inflammation. Temporomandibular joint dysfunction is often seen in JIA patients. Consequently, special dental care programs would be recommendable.

show abstract

Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement

Cited by 29 publications

References 20 publications

Condylar alterations and facial growth in children with juvenile idiopathic arthritis

Condylar alterations and facial growth in children with juvenile idiopathic arthritis

Quantitative analysis of facial asymmetry based on three-dimensional photography: a valuable indicator for asymmetrical temporomandibular joint affection in juvenile idiopathic arthritis patients?

Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis—A Cross-Sectional Study

Contact Info

Product

Resources

About