Pathological changes in the TMJ and the length of the ramus in patients with confirmed juvenile idiopathic arthritis

J Craniomaxillofac Surg. 2014 Dec;42(8):1802-7. doi: 10.1016/j.jcms.2014.06.018. Epub 2014 Jun 19.

Abstract

Introduction: Juvenile idiopathic arthritis (JIA) is characterized by a progressive destruction of the joints. The temporomandibular joints (TMJ) are especially likely to be affected. The often undetected arthritis in the TMJ in particular can cause significant destruction and craniofacial developmental abnormalities. The aim of this study was to analyze the destructive impact of JIA on TMJ and mandibular development.

Material and methods: We analyzed a total of 92 joints and mandibular rami using digital cone-beam tomography (CBT) and compared 23 consecutively treated JIA patients with 23 healthy controls, matched for age and gender. We evaluated ramus length, vertical depth of the articular fossa, anterior-posterior dimensions of the mandibular head and condylar process. The statistical analysis was performed using non-parametric Wilcoxon and Kruskal-Wallis Rank Sum tests.

Results: The JIA patients exhibited significantly more pronounced asymmetries. However, we were unable to detect significant differences in the metric measuring distances. The different JIA subtypes exerted no statistically significant influence.

Conclusions: The possible destruction arising as a result of JIA concerns the TMJ and the length of the mandibular ramus. These craniofacial anomalies demonstrate the central importance of sufficiently early detection and timely treatment in the prevention of such growth disturbances.

Keywords: Cone beam tomography; Facial asymmetry; Growth disturbances; JIA; TMJ arthritis; Temporomandibular joint.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Arthritis, Juvenile / diagnostic imaging*
  • Case-Control Studies
  • Cephalometry / methods
  • Child
  • Cone-Beam Computed Tomography / methods
  • Early Diagnosis
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Male
  • Mandible / diagnostic imaging*
  • Mandibular Condyle / diagnostic imaging
  • Maxillofacial Development / physiology
  • Temporal Bone / diagnostic imaging
  • Temporomandibular Joint / diagnostic imaging*
  • Temporomandibular Joint Disorders / diagnostic imaging*