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Cranial structure and condylar asymmetry of patients with juvenile idiopathic arthritis: a risky growth pattern

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Abstract

The aim of the study was to evaluate the cephalometric differences and condylar asymmetry between patients with juvenile idiopathic arthritis (JIA) and normal control group. Sixty-two JIA patients with a latero-lateral cephalogram and orthopantomography, seeking for orthodontic therapy, and 62 normal matched subjects were comprised in the study. Cephalometric analysis was used for the evaluation of facial morphology while the method of Habets et al. (J Oral Rehabil 15(5): 465–471, 1988) was used to compare the condyles in orthopantomography. The significance of between-group differences was assessed using the Mann–Whitney test, as appropriate. The results showed a prevalence of the upper maxilla with hypomandibulia (class II), hyperdivergency with short vertical ramus posterior and posterior rotation of the mandible in JIA children (SNB, ANB, NSL/ML, Fh/ML, NL/ML, ArGo, ML P < 0.0001, ML/Oc P < 0.004, ArGo/GoGn P = 0.02, no difference for SNA). The condyles of the JIA group resulted highly asymmetric (P < 0.0001). The growth pattern of JIA patients resulted clearly different from normal subjects. This serious impairment of the cranial growth may be considered as an indicator of the need for early and continuous orthognatodonthic therapy during the entire period of development for all JIA patients, independently from temporomandibular joint signs or symptoms. To this end, it is important that rheumatologists and orthognathodontists set up a multidisciplinary treatment planned to control the side effects of a deranged growing pattern, to strictly avoid any orthodontic therapies that may worsen function and growth, and to promote treatments improving the physiology and biology of the cranial development.

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Authors and Affiliations

  1. Department of Surgical Sciences-Orthodontic division, Dental School, University of Turin, Turin, Italy

    Maria Grazia Piancino & Rosangela Cannavale

  2. Turin, Italy

    Maria Grazia Piancino

  3. Department of Public Health and Paediatrics, University of Turin, Turin, Italy

    Paola Dalmasso

  4. Orthodontic Division, Dental School, University of Brescia, Brescia, Italy

    Ingrid Tonni

  5. Department of Biomedical Sciences, University of Milan, Milan, Italy

    Umberto Garagiola

  6. Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, Italy

    Letizia Perillo

  7. Department of Woman and Child and General and Specialized Surgery, University of Campania , Luigi Vanvitelli, Italy

    Alma Nunzia Olivieri

Authors
  1. Maria Grazia Piancino
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  2. Rosangela Cannavale
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  3. Paola Dalmasso
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  4. Ingrid Tonni
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  5. Umberto Garagiola
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  6. Letizia Perillo
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  7. Alma Nunzia Olivieri
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Piancino, M.G., Cannavale, R., Dalmasso, P. et al. Cranial structure and condylar asymmetry of patients with juvenile idiopathic arthritis: a risky growth pattern. Clin Rheumatol 37, 2667–2673 (2018). https://doi.org/10.1007/s10067-018-4180-5

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  • DOI: https://doi.org/10.1007/s10067-018-4180-5

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