Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement. YJ Hsieh, TA Darvann, NV Hermann, P Larsen, YF Liao, J Bjoern-Joergensen, S Kreiborg.

Date: February 2016
Source: American Journal of Orthodontics & Dentofacial Orthopedics. Volume 149, Issue 2, Pages 182–191.
Highlights:
• We evaluated lateral facial morphology of juvenile idiopathic arthritis patients with moderate and severe TMJ involvement.
• Differences in their lateral facial morphologies between unilateral and bilateral TMJ involvement were also assessed.
Introduction: The aims of this study were to (1) assess lateral facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint (TMJ) involvement, (2) compare the lateral facial morphology of these subjects with and without TMJ involvement using cephalograms and 3-dimensional (3D) facial photographs, and (3) compare and correlate the results of the 3D photographic and cephalometric analyses.
Methods: Sixty patients with juvenile idiopathic arthritis were included and grouped as follows: group 1, juvenile idiopathic arthritis patients without TMJ involvement; group 2, juvenile idiopathic arthritis patients with moderate to severe unilateral TMJ involvement; and group 3, juvenile idiopathic arthritis patients with moderate to severe bilateral TMJ involvement. Lateral cephalograms were used to assess and compare lateral facial morphologies between the groups. Lateral projections of oriented 3D photographs were superimposed on the lateral cephalograms. The results of the lateral 3D photographic analysis were correlated with those of lateral cephalometric analysis.
Results: Group 3 showed the most severe growth disturbances, including more retrognathic mandible and retruded chin, steep occlusal and mandibular planes, and more hyperdivergent type (P <0.01). Group 2 showed similar growth disturbances, but to a lesser extent than did group 3. Photographic variables were significantly correlated with the soft tissue and skeletal variables of cephalograms (0.5 < r < 0.9; P <0.001). Conclusions: Subjects with juvenile idiopathic arthritis and unilateral or bilateral moderate to severe TMJ involvement had significant growth disturbances. Early intervention is recommended for these patients to prevent unfavorable facial development. Furthermore, with proper orientation, 3D photographs can be used as an alternative to conventional lateral cephalograms and 2-dimensional photographs.
Article: Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement.
Authors: Yuh-Jia Hsieh, Tron A. Darvann, Nuno V. Hermann, Per Larsen, Yu-Fang Liao, Jens Bjoern-Joergensen, Sven Kreiborg. 3D Craniofacial Image Research Laboratory, School of Dentistry, University of Copenhagen; Copenhagen University Hospital Rigshospitalet; and Department of Applied Mathematics and Computer Science, Technical University of Denmark, Copenhagen, Denmark; attending orthodontist, Department of Craniofacial Orthodontics and Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.