Background: Patients affected by juvenile idiopathic arthritis (JIA) may have several craniofacial growth disturbances and involvements at the temporomandibular joint (TMJ). The objectives of the present study were to evaluate the clinical effectiveness of functional therapy used to reduce asymmetry of mandibular growth and TMJ disorder in patients with JIA. Methods: By a retrospective longitudinal design, a cohort of 54 patients with JIA (mean age, 13.2±3.7 years; range, 5-17.7 years) and with TMJ involvements was enrolled in the study. Each patient, following the collection of clinical parameters, was treated for 24 months with a functional appliance individually customized by acrylic resin and resilient stainless steel with posterior and anterior metallic bite planes preventing the teeth from intercuspal contact. To evaluate differences before (T0) and after therapy (T1) of the clinical TMJ parameters, the statistical analysis by the χ2 Test was performed. Results: All the patients completed successfully the study. In patients with JIA, the use of a functional appliance determined a statistically significant difference of the pain during jaw movement, maximal mouth opening, TMJ sounds and crepitations (P<0.001) and TMJ click, significantly reduced at T1 (P<0.05). Conclusions: The use of an orthodontic functional appliance determined a significant improvement, at 24 months, in many TMJ signs and symptoms in patients affected by JIA and with TMJ disorders. This study suggests that children and adolescents with JIA which presented either unilateral or bilateral moderate to severe TMJ involvement, if not treated, should be develop severe disturbances during growing.

The effect of a functional appliance in the management of temporomandibular joint disorders in patients with juvenile idiopathic arthritis

Isola G
Writing – Review & Editing
;
2017

Abstract

Background: Patients affected by juvenile idiopathic arthritis (JIA) may have several craniofacial growth disturbances and involvements at the temporomandibular joint (TMJ). The objectives of the present study were to evaluate the clinical effectiveness of functional therapy used to reduce asymmetry of mandibular growth and TMJ disorder in patients with JIA. Methods: By a retrospective longitudinal design, a cohort of 54 patients with JIA (mean age, 13.2±3.7 years; range, 5-17.7 years) and with TMJ involvements was enrolled in the study. Each patient, following the collection of clinical parameters, was treated for 24 months with a functional appliance individually customized by acrylic resin and resilient stainless steel with posterior and anterior metallic bite planes preventing the teeth from intercuspal contact. To evaluate differences before (T0) and after therapy (T1) of the clinical TMJ parameters, the statistical analysis by the χ2 Test was performed. Results: All the patients completed successfully the study. In patients with JIA, the use of a functional appliance determined a statistically significant difference of the pain during jaw movement, maximal mouth opening, TMJ sounds and crepitations (P<0.001) and TMJ click, significantly reduced at T1 (P<0.05). Conclusions: The use of an orthodontic functional appliance determined a significant improvement, at 24 months, in many TMJ signs and symptoms in patients affected by JIA and with TMJ disorders. This study suggests that children and adolescents with JIA which presented either unilateral or bilateral moderate to severe TMJ involvement, if not treated, should be develop severe disturbances during growing.
Arthritis; Functional - Child; Juvenile - Temporomandibular joint - Temporomandibular Joint Disorders - Therapeutics - Orthodontic appliances; Adolescent; Arthralgia; Arthritis, Juvenile; Arthritis, Rheumatoid; Cephalometry; Child; Female; Humans; Male; Mandible; Movement; Orthodontic Appliance Design; Retrospective Studies; Temporomandibular Joint Disorders; Treatment Outcome; Orthodontic Appliances, Functional; Surgery; Oral Surgery; Otorhinolaryngology2734 Pathology and Forensic Medicine
File in questo prodotto:
File Dimensione Formato  
Isola et al Minerva 2017.pdf

non disponibili

Tipologia: Versione Editoriale (PDF)
Dimensione 533.24 kB
Formato Adobe PDF
533.24 kB Adobe PDF   Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/346942
Citazioni
  • ???jsp.display-item.citation.pmc??? 26
  • Scopus 45
  • ???jsp.display-item.citation.isi??? 44
social impact