Long-term follow-up of craniofacial alterations in juvenile idiopathic arthritis

Objective: To investigate changes in the craniofacial skeleton in relation to the changes in condylaralterations that occur during long-term follow-up in patients with juvenile idiopathic arthritis. Materials and Methods: Temporomandibular joint (TMJ) involvement is defined as a condylaralteration that is observed on the orthopantomogram. Lateral cephalograms were used to determine linear and angular measurements. Results: Seventy of 97 patients from the initial study cohort were included, with a mean follow up of 68 months. The overall prevalence of condylar alterations and posterior rotation of them andible decreased; however, the prevalence of retrognathia remained the same. Patients showed improvement in the degree of retrognathia and posterior rotation (40% ANB, 51% OPSN,and 44% GO-GN-SN). Improvement in the degree of retrognathia was seen more often inpatients with improved condylar alterations than in patients with persistent alterations and in those without alterations (50%, 33%, and 28%, respectively). The degree of posterior rotation improved almost equally in patients without TMJ involvement and in patients with improved condylar alterations(57% and 50% by OP-SN, and 67% and 38% GO-GN-SN, respectively) and did not improve in patients with stable persistent alterations. Conclusion: Both condylar and craniofacial alterations can improve in patients with juvenile idiopathicarthritis. (Angle Orthod. 2009;79:1057-1062.)

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