Cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis

Maria Grazia Piancino; Rossana Rotolo; Rosangela Cannavale; Giovanna Cuomo; Francesco Masini; Paola Dalmasso; Fabrizia D'Apuzzo; Letizia Perillo; Ludovica Nucci

doi:10.1186/s12903-023-03001-2

Cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis

BMC Oral Health. 2023 May 9;23(1):269. doi: 10.1186/s12903-023-03001-2.

Authors

Maria Grazia Piancino¹, Rossana Rotolo², Rosangela Cannavale³, Giovanna Cuomo⁴, Francesco Masini⁵, Paola Dalmasso⁶, Fabrizia D'Apuzzo², Letizia Perillo², Ludovica Nucci²

Affiliations

¹ Department of Surgical Sciences-Orthodontic Division, Italian Research Center, University of Turin, Turin, Italy.
² Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of the Study of Campania Luigi Vanvitelli, Naples, Italy.
³ Department of Surgical Sciences-Orthodontic Division, Italian Research Center, University of Turin, Turin, Italy. cannavale@alice.it.
⁴ Department of Precision Medicine, University of the Study of Campania Luigi Vanvitelli, Naples, Italy.
⁵ Department of Medical and Surgical Sciences, University of the Study of Campania Luigi Vanvitelli, Naples, Italy.
⁶ Department of Public Health and Paediatrics, University of Turin, Turin, Italy.

Abstract

Objective: The aim of this prospective cross sectional study was to evaluate the cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis (RA) diagnosed after 25 years of age compared to a healthy adult control group.

Methods: Eighteen adult patients (57.4 ± 11.4 years) with RA were compared with a control group. Cephalometric analysis and the Habets method for the calculation of the condylar asymmetry were used. The main cephalometric data investigated were focused on the diagnosis of hyperdivergent cranial structure (NSL/ML, NL/ML), backwards rotation of the mandible (Fh/ML), short vertical ramus (Ar:Go), steep mandibular plane (ML/Oc).

Results: The cephalometric data considered were not significantly different in the RA vs controls except for the steepness of the occlusal plane (NL/Oc), which was steeper in the patients group (P < 0.02) and the ramus of the mandible which was greater in patients. The asymmetry of the condyles was significant (P < 0.003) and different from the control group, but that of the ramus was not.

Conclusions: In this study, RA patients diagnosed after 25 years of age did not show a different pattern of growth with respect to the control group. As expected, the condyles showed a difference being asymmetrical in RA patients due to the high turnover of this joint reacting to severe systemic inflammation in conditions of continuous functional work, load and forces. This study follows a previous study with the same research plan conducted on young JIA patients who showed a different pattern of growth of the skull leading to a severe hyperdivergent cranial structure with backward rotation of the mandible; this is mainly due to the insufficient growth of the condylar site exposed to the inflammatory process during development. Unlike JIA patients, this study showed that RA patients follow an individual growth pattern not affected by inflammation, even if they show joint asymmetry.

Keywords: Arthritis, rheumatoid; Cephalometry; Facial asymmetry; Mandibular condyle; Orthopantomography; Temporomandibular joint.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Arthritis, Rheumatoid* / complications
Cross-Sectional Studies
Humans
Inflammation
Polymers
Prospective Studies
Skull*

Substances

Polymers