Radiographic Temporomandibular Joint Abnormality in Adults with Micrognathia and Juvenile Rheumatoid Arthritis

Abstract

Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia.

Juvenile idiopathic arthritis—and now?

“…For reasons of comparability the evaluation in this article was restricted to the most frequently used angles for the sagittal and vertical jaw base relationship (ANB and ML/NSL). ANB angles between 4.1° and 11.05° were reported in the evaluated studies; however, the group reporting an ANB of 11.05° defined micrognathia as an inclusion criterion [25,26]. Regarding the vertical morphology: the included studies report a mean ML/NSL angle between 28.1° and 51° (note: 51° was reported by the group that Die Artikel mussten in einer der folgenden Sprachen verfasst sein: Dänisch, Deutsch, Englisch, Französisch, Griechisch, Italienisch, Schwedisch oder Spanisch.…”

“…The patients' age range was clearly defined in just 5 of the 19 publications. All of those five studies involved the Oslo subject cohort [1,10,11,25,26]. In all the others, patient age was provided, but the age range was often so great that patients of different developmental periods (e.g., infancy and post-puberty) were evaluated without differentiation (Table 7).…”

“…In all the others, patient age was provided, but the age range was often so great that patients of different developmental periods (e.g., infancy and post-puberty) were evaluated without differentiation (Table 7). Eleven groups of authors provided data on disease duration [1,10,11,12,13,15,25,26,27,36,47] and five on occlusion [4,13,20,36,38]. Only four studies provided information on whether the patients were treated orthodontically [9,10,11,15].…”

“…Seven groups of authors provided information on general JIA medication [1,6,12,13,25,26,36], but they were extremely heterogeneous, even within the individual studies.…”

“…Im Großteil der Untersuchungen fand zwar eine Angabe, nicht aber eine differenzierte Analyse der verschiedenen JIA-Subtypen statt. So analysierten acht der 19 Autorengruppen alle JIAArten gepoolt [1,4,6,10,11,13,46,47], drei fassten die drei Hauptarten (Oligo-, Poly-, systemische Arthritis) zusammen [15,36,39] und weitere sieben untersuchten Patienten mit Oligo-und Polyarthritis [9,20,25,26,27,39,40]. Lediglich eine Studie beschränkte sich spezifisch auf Patienten mit einer systemischen Manifestation der Erkrankung ( [12], Tabelle 4).…”