Craniofacial growth in children affected by juvenile idiopathic arthritis involving the temporomandibular joint: functional therapy management

J Clin Pediatr Dent. 2009 Summer;33(4):351-7. doi: 10.17796/jcpd.33.4.05287m400q508772.

Abstract

The aim of this study was twofold: 1) to asses the effects of a functional appliance on condyles damaged by juvenile idiopathic arthritis (JIA). and 2) to evaluate its ability to reduce alterations in craniofacial development.

Study design: Seventy-two JIA patients with temporomandibular involvement, ages ranging between 4 and 16 years, were treated. All of them presented temporomandibular joint involvement. They were treated with an activator and followed for 4 years.

Results: At the second examination, it was possible to observe a reduction in mandibular retrusion and in the sagittal discrepancy between mandible and maxilla, a reduction in the angle of divergence, a counterclockwise rotation of the mandible, a reduction of the gonial angle, a longer mandibular ramus, a reduction in the discrepancy between anterior and posterior height caused by an increase in posterior height and a forward positioning of the chin.

Conclusion: The functional appliance reduces the severity of facial alterations improving mandibular and condylar growth.

MeSH terms

  • Arthritis, Juvenile / diagnostic imaging
  • Arthritis, Juvenile / physiopathology*
  • Arthritis, Juvenile / therapy
  • Cephalometry / statistics & numerical data
  • Child
  • Female
  • Humans
  • Male
  • Mandible / growth & development
  • Mandible / pathology
  • Maxillofacial Development*
  • Myofunctional Therapy / instrumentation*
  • Orthodontic Appliances, Functional*
  • Radiography
  • Retrognathia / physiopathology
  • Retrognathia / therapy
  • Temporomandibular Joint Disorders / diagnostic imaging
  • Temporomandibular Joint Disorders / physiopathology*
  • Temporomandibular Joint Disorders / therapy