Limited Mandibular Movements as a Consequence of Unilateral or Asymmetrical Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis Patients

Abstract

This study aimed to assess the asymmetry of the lower face and motor dysfunction of the masticatory system resulting from unilateral or asymmetrical bilateral temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients. The study consisted of clinical examination and cone beam computed tomography (CBCT) of TMJs. Statistical analysis showed correlations between several factors: facial asymmetry and mandibular lateral deviation; the direction of mandibular deviation and the degree of radiological deformities in TMJs; the child’s age at the time of the onset and the range of lateral movement towards the healthy or less destructed joint. In addition, there was a significant difference in ranges of lateral movements; a significantly smaller range was observed for the joint with fewer condylar abnormalities compared to the range in the opposite direction. In JIA children, among the clinical markers of unilateral or asymmetrical TMJ involvement, the asymmetry of the lower face, deviation of the mandible on opening, and an uneven range of mandibular lateral movements deserve attention. The obtained results do not show a relationship between the degree of condylar changes and the asymmetry of the lower face and the presence and degree of mandibular motor dysfunction.

What is the correlation between Juvenile Idiopathic Arthritis and the image appearance of MRI, CT, and CBCT findings in TMJ? A systematic review

“…However, some authors related the presence of TMD (21;30) without using or reporting the use of RDC/TMD or DC/TMD -Diagnostic Criteria for Temporomandibular Disorders (Schiffman et al, 2015;Schiffman et al, 2016). Some authors reported the presence of patients with and without TMJ pain [21,23,26,27,30]. Abramowicz et al, 2011 did not evaluate the presence of pain.…”

“…Regarding ILAR classi cation criteria (Krumrey, et al, 2001), among all 227 JIA patients, 6 (2.6%) presented systemic arthritis, 43 (18.9%) oligoarthritis, and 11 (4.8%) had oligoarthritis extended, 117 (51.5%) presented polyarthritis, being 6 (5.2%) with rheumatoid factor positive polyarthritis, 82 (70%) rheumatoid factor negative polyarthritis and 29 (24.8%) patients in three studies were designated as polyarthritis, without specifying the type [21,27,30]. Also, 29 (12.8%) patients had psoriatic arthritis, 13 (5.7%) enthesitis-related arthritis and 8 (3.5%) other classi cation.…”

CBCT Analysis of Dento-Skeletal Changes after Rapid versus Slow Maxillary Expansion on Deciduous Teeth: A Randomized Clinical Trial

“…RME affects not only midpalatal suture, but also circumaxillary sutures [ 6 ]. Although it is a treatment commonly used by clinicians, it might present some disadvantages: when the appliance is anchored to permanent teeth, it might cause their buccal tipping, root resorption, bone fenestration, and reduced buccal bone thickness [ 7 , 8 ]. To avoid these effects, palatal expansion in growing patients can be achieved by using primary teeth as anchorage [ 2 , 9 ].…”

Evaluation of Mandibular Growth and Symmetry in Child with Congenital Zygomatic-Coronoid Ankylosis

“…These refer to clinical multi-cause disorders in the morphological and functional system, including tissues and organs within the oral cavity and the facial skeleton (bones and soft tissues, cartilaginous joints). Therefore, the disorders in the area of the temporomandibular joint (TMJ), ankyloses of various origin, occlusion disorders, hyperplasia or hypoplasia of condylar processes of the mandible, cysts and tumors may change the course of the mandible's development [5,13,14]. In addition, the proper growth in the posterior direction [15] and the resistance to compressive forces [16] may be disturbed by some disorders.…”