Juvenile idiopathic arthritis—and now?

A systematic literature review of changes in craniofacial morphology
Review article

Abstract

Aim

To conduct a systematic literature review on the impact of juvenile idiopathic arthritis (JIA) on craniofacial morphology.

Materials and methods

Several electronic databases (PubMed, Medpilot, Web of Science, DIMDI) were systematically searched for studies that were published up to and including May 2011. In addition, a manual search of the orthodontic and rheumatologic literature was conducted, and reference lists of the selected articles were checked for relevant publications. The identified articles were independently assessed by two investigators and selected according to a three-step process (title/abstract/full text).

Results

After completion of the selection procedure, 19 articles were identified possessing great heterogeneity. In most of them, no differentiated analysis of the various JIA subtypes was performed, and type-specific analyses according to mandibular joint effects were seldom. Additional factors such as patient age, disease duration, medication, previous orthodontic treatment as well as the inclusion of a control group were also highly inhomogeneous, which made a meta-analysis of the data impossible. Nevertheless, it appears as if JIA patients tend to develop a hyperdivergent vertical jaw base relationship and a skeletal Class II pattern.

Conclusion

Due to the heterogeneous patient samples, it is currently not possible to draw a differentiated conclusion on the influence of various types of JIA on craniofacial morphology.

Keywords

Juvenile idiopathic arthritis Review Morphology Temporomandibular joint  

Juvenile idiopathische Arthritis – und nun?

Eine systematische Literaturübersicht über Veränderungen der kraniofazialen Morphologie

Zusammenfassung

Zielsetzung

Durchführung einer systematischen Literaturrecherche zum Einfluss der juvenilen idiopathischen Arthritis (JIA) auf die kraniofaziale Gesichtsschädelmorphologie.

Material und Methoden

Mehrere elektronische Datenbanken (PubMed, Medpilot, Web of Science, DIMDI) wurden systematisch nach Studien durchsucht, die bis einschließlich 05/2011 publiziert worden waren. Des Weiteren wurden eine Handsuche der kieferorthopädischen und rheumatologischen Fachliteratur vorgenommen sowie die Referenzlisten der ausgewählten Artikel nach geeigneten Publikationen durchsucht. Die ermittelten Artikel wurden unabhängig von zwei Untersuchern bewertet und nach einem dreischrittigen Verfahren (Titel − Abstract − Volltext) ausgewählt.

Ergebnisse

Nach Abschluss des Auswahlverfahrens standen 19 Artikel zur Verfügung, welche sich durch eine hohe Heterogenität auszeichneten. Im Großteil der Untersuchungen war keine differenzierte Analyse der verschiedenen JIA-Subtypen durchgeführt worden, auch eine differenzierte Auswertung nach Kiefergelenksbefall war selten erfolgt. Auch weitere Angaben (Alter der Patienten, Erkrankungsdauer, Medikation, kieferorthopädische Vorbehandlung) sowie eine geeignete Kontrollgruppe waren in höchstem Maße uneinheitlich, was eine Metaanalyse der Daten nicht möglich machte. Es scheint jedoch so, als sei die Kieferlagebeziehung bei JIA-Patienten in Richtung einer skeletalen Klasse II sowie einer hyperdivergenten Kieferrelation verändert.

Schlussfolgerung

Derzeit ist aufgrund des inhomogenen Patientengutes keine differenzierte Aussage zum Einfluss verschiedener JIA-Arten auf die kraniofaziale Morphologie möglich.

Schlüsselwörter

Juvenile idiopathische Arthritis Review Morphologie Kiefergelenk 

Notes

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Orthodontics, Medical Center for Dental and Oral MedicineJustus Liebig UniversityGiessenGermany

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