No association between types of unilateral mandibular condylar abnormalities and facial asymmetry in orthopedic-treated patients with juvenile idiopathic arthritis

Stoustrup, Peter; Ahlefeldt-Laurvig-Lehn, Nicole; Kristensen, Kasper Dahl; Arvidsson, Linda Z.; Twilt, Marinka; Cattaneo, Paolo M.; Küseler, Annelise; Christensen, Anne Estmann; Herlin, Troels; Pedersen, Thomas Klit

doi:10.1016/j.ajodo.2017.05.037

Cited by 19 publications

(18 citation statements)

References 28 publications

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“…However, contrary to our expectations, we did not observe inter-group differences between the three JIA groups in asymmetry-based measures like total posterior height 1 and 2 (No.1,2), and maxillary and mandibular occlusal canting (No.8,9). This could be explained by the classification of the JIA groups based on radiographic appearance; contemporary theory explains the development of dentofacial growth deviation in JIA as a consequence of condylar growth disturbance rather than condylar damage [ 4 , 17 , 34 – 36 ]. Therefore, the radiographic appearance of the condyle may be normal even when growth at that condyle has been impaired.…”

Section: Discussionmentioning

confidence: 99%

“…All proposed morphometric measurements were made for each subject by one author (CKI). Additionally, the radiographic appearance of each TMJ was categorized based on published criteria [ 17 ]:…”

Section: Methodsmentioning

confidence: 99%

“…Several protocols for 3D radiographic evaluation of facial asymmetry and malocclusion have been published recently for non-JIA subjects [ 10 – 14 ]. In patients with JIA and TMJ involvement, 3D morphometric measures have been used to assess dentofacial abnormalities [ 15 – 17 ], but no standardized guidelines exist for the 3D radiographic evaluation of dentofacial growth deviation in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of dentofacial growth deviation in juvenile idiopathic arthritis: Reliability and validity of three-dimensional morphometric measures

et al. 2018

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IntroductionPatients with juvenile idiopathic arthritis (JIA) and involvement of the temporomandibular joint (TMJ) often experience abnormal facial growth. Three-dimensional (3D) assessment of dentofacial growth deviation has become more common with advancement and commercialization of imaging technologies. However, no standardized guidelines exist for interpretation of 3D imaging in patients with JIA. The aim of this study was to propose and validate morphometric measures for the 3D radiographic assessment of dentofacial growth deviation in patients with JIA to enhance: 1) Description of dentofacial growth deviation; 2) Treatment planning; 3) Longitudinal follow-up.MethodsThe study was conducted in a standardized sequential-phased approach involving: 1) Preliminary decision-making; 2) Item generation; 3) Test of content-validity; 4) Test of reliability; 5) Test of construct validity; 6) Establishment of final recommendations.ResultsTwenty-one morphometric measures were evaluated. Based on results of reliability and validity-testing including subjects with JIA (n = 70) and non-JIA controls (n = 19), seven measures received a “high recommendation” score. Those measures were associated with posterior mandibular height, occlusal cant, mandibular asymmetry, mandibular inclination, and anterior/posterior lower face height. Nine other measures were “moderately recommended” and five received a “somewhat recommendation” score.ConclusionSeven morphometric measures were considered very useful in the 3D assessment of growth deviation in patients with TMJ disease associated with JIA. These variables can be used to standardize the description of dentofacial deformities and to plan corrective interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of dentofacial growth deviation in juvenile idiopathic arthritis: Reliability and validity of three-dimensional morphometric measures

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“…Unilateral TMJ involvement (or a more advanced form in one of the joints) may cause uneven growth of the right and left side of the jaw and cause ramus shortening as well as reducing the size mandibular body on the damaged side [ 5 , 28 ]. Consequently, this may lead to increased facial asymmetry [ 4 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 25 , 26 , 29 ]. In research by Keller et al (2015) [ 10 ], facial asymmetry, assessed independently by a rheumatologist and an orthodontist, was recorded in 37% and 41% of 76 examined JIA patients aged 1.9–18.6 years old, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological evaluation was blinded to the clinical data. Based on the CBCT scans all of the 39 patients were classified, taking into account the grading system by Billiau et al (2007) [ 21 ] for each of two TMJs, to one of the subgroup: JIA 0-0, JIA 0-1, JIA 0-2, JIA 0-3, JIA 0-4, JIA 1-1, JIA 1-2, JIA 1-3, JIA 1-4, JIA 2-2, JIA 2-3, JIA 2-4, JIA 3-3, JIA 3-4, JIA 4-4 [ 25 ]. In compliance with the inclusion criteria of these study patients with unilateral or bilateral with different scores of the index on both condylar process (when one of the two sides TMJ was affected more severely concerning the other one), joint involvement was qualified for further analysis.…”

Section: Methodsmentioning

confidence: 99%

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

Pawlaczyk−Kamieńska

Kulczyk

Pawlaczyk-Wróblewska

et al. 2020

JCM

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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.

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Cumulative Incidence of Orofacial Manifestations in Early Juvenile Idiopathic Arthritis: A Regional, Three‐Year Cohort Study

Stoustrup

Glerup

Bilgrau

et al. 2020

Arthritis Care & Research

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Objectives: To estimate the cumulative incidence of arthritis-induced orofacial symptoms, dysfunctions, and dentofacial deformities in growing individuals with juvenile idiopathic arthritis (JIA) in a 36 month regional cohort study, and to identify predictors for the development of arthritis-induced dentofacial deformities.Methods: Data was retrieved from the Aarhus JIA TMJ cohort register, which contains standardized, longitudinal, observational data regarding orofacial conditions in patients with JIA (n=1040). This regional cohort represents the majority of all subjects with JIA from the western part of Denmark between 1990 and 2016, regardless of temporomandibular joint (TMJ) arthritis status. Cumulative incidences of orofacial conditions were reported using Kaplan-Meier methods and predictors for dentofacial deformity was identified using Cox proportional hazard analysis.Results: Follow-up data from 351 subjects over thirty-six months was included in this study.Median age at first clinical examination was 6.6 years (25/75 centiles: 4.9 and 9.9 years).Orofacial symptoms and dysfunction were common findings at 36 months after the first clinical examination and approximately five years after JIA onset, with a cumulative incidence of 38% and 53%, respectively. Dentofacial deformities were found in 35% of

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No association between types of unilateral mandibular condylar abnormalities and facial asymmetry in orthopedic-treated patients with juvenile idiopathic arthritis

Cited by 19 publications

References 28 publications

Assessment of dentofacial growth deviation in juvenile idiopathic arthritis: Reliability and validity of three-dimensional morphometric measures

Assessment of dentofacial growth deviation in juvenile idiopathic arthritis: Reliability and validity of three-dimensional morphometric measures

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

Cumulative Incidence of Orofacial Manifestations in Early Juvenile Idiopathic Arthritis: A Regional, Three‐Year Cohort Study

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