Skip to main content
SpringerLink
Log in

Juvenile idiopathic arthritis—and now?

A systematic literature review of changes in craniofacial morphology

Juvenile idiopathische Arthritis – und nun?

Eine systematische Literaturübersicht über Veränderungen der kraniofazialen Morphologie

  • Review article
  • Published:
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

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.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Arvidsson LZ, Fjeld MG, Smith HJ et al (2010) Craniofacial growth disturbance is related to temporomandibular joint abnormality in patients with juvenile idiopathic arthritis, but normal facial profile was also found at the 27-year follow-up. Scand J Rheumatol 39:373–379

    Article  PubMed  Google Scholar 

  2. Arvidsson LZ, Flatø B, Larheim TA (2009) Radiographic TMJ abnormalities in patients with juvenile idiopathic arthritis followed for 27 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:114–123

    Article  PubMed  Google Scholar 

  3. Bache C (1964) Mandibular growth and dental occlusion in juvenile rheumatoid arthritis. Acta Rheum Scand 10:142–153

    Article  PubMed  Google Scholar 

  4. Barriga B, Lewis TM, Law DB (1974) An investigation of the dental occlusion in children with juvenile rheumatoid arthritis. Angle Orthod 44:329–335

    PubMed  Google Scholar 

  5. Bayar N, Kara SA, Keles I et al (2002) Temporomandibular joint involvement in rheumatoid arthritis: a radiological and clinical study. Cranio 20:105–110

    PubMed  Google Scholar 

  6. Billiau AD, Hu Y, Verdonck A et al (2007) Temporomandibular joint arthritis in juvenile idiopathic arthritis: prevalence, clinical and radiological signs, and relation to dentofacial morphology. J Rheumatol 34:1925–1934

    PubMed  Google Scholar 

  7. Cannizzaro E, Schroeder S, Müller LM et al (2011) Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol 38:510–515

    Article  PubMed  Google Scholar 

  8. Engel MB, Richmond J, Brodie TG (1949) Mandibular growth disturbances in rheumatoid arthritis of childhood. Am J Dis Child 78:728–743

    PubMed  Google Scholar 

  9. Farronato G, Carletti V, Maspero C et al (2009) Craniofacial growth in children affected by JIA involving the TMJ: functional therapy. J Clin Pediatr Dent 33:351–357

    PubMed  Google Scholar 

  10. Fjeld M, Arvidsson L, Smith HJ et al (2010) Relationship between disease course in the temporomandibular joints and mandibular growth rotation in patients with juvenile idiopathic arthritis followed from childhood to adulthood. Pediatr Rheumatol Online J 22(8):13

    Article  Google Scholar 

  11. Fjeld MG, Arvidsson LZ, Stabrun AE et al (2009) Average craniofacial development from 6–35 years of age in a mixed group of patients with juvenile idiopathic arthritis. Acta Odontol Scand 67:153–160

    Article  PubMed  Google Scholar 

  12. Hanna VE, Rider SF, Moore TL et al (1996) Effects of systemic onset juvenile rheumatoid arthritis on facial morphology and temporomandibular joint form and function. J Rheumatol 23:155–158

    PubMed  Google Scholar 

  13. Hu Y, Billiau AD, Verdonck A et al (2009) Variation in dentofacial morphology and occlusion in juvenile idiopathic arthritis subjects: a case-control study. Eur J Orthod 31:51–58

    Article  PubMed  Google Scholar 

  14. Hu YS, Schneiderman ED (1995) The temporomandibular joint in juvenile rheumatoid arthritis: I. Computed tomographic findings. Pediatr Dent 17:46–53

    PubMed  Google Scholar 

  15. Hu YS, Schneiderman ED, Harper RP (1996) The temporomandibular joint in juvenile rheumatoid arthritis: Part II. Relations between computed tomographic and clinical findings. Pediatr Dent 18:312–319

    PubMed  Google Scholar 

  16. Ince DO, Ince A, Moore TL (2000) Effect of methotrexate on the temporomandibular joint and facial morphology in juvenile rheumatoid arthritis patients. Am J Orthod Dentofacial Orthop 118:75–83

    Article  PubMed  Google Scholar 

  17. Jank S, Haase S, Strobl H et al (2007) Sonographic investigation of the temporomandibular joint in patients with juvenile idiopathic arthritis: a pilot study. Arthritis Rheum 57:213–218

    Article  PubMed  Google Scholar 

  18. Jank S, Schröder D, Haase S et al (2003) Kiefergelenksbeschwerden bei juvenilen Patienten mit theumatischen Erkrankungen. Mund Kiefer Gesichtschir 7:214–219

    Article  PubMed  Google Scholar 

  19. Karhulahti T, Ylijoki H, Ronning O (1993) Mandibular condyle lesions related to age at onset and subtypes of juvenile rheumatoid arthritis in 15-year-old children. Scand J Dent Res 101:332–338

    PubMed  Google Scholar 

  20. Kjellberg H, Fasth A, Kiliaridis S et al (1995) Craniofacial structure in children with juvenile chronic arthritis (JCA) compared with healthy children with ideal or postnormal occlusion. Am J Orthod Dentofacial Orthop 107:67–78

    Article  PubMed  Google Scholar 

  21. Kjellberg H, Kiliaridis S, Thilander B (1995) Dentofacial growth in orthodontically treated and untreated children with juvenile chronic arthritis (JCA). A comparison with angle class II division 1 subjects. Eur J Orthod 17:357–373

    PubMed  Google Scholar 

  22. Kjellberg H (1998) Craniofacial growth in juvenile chronic arthritis. Acta Odont Scand 56:360–365

    Article  PubMed  Google Scholar 

  23. Kreiborg S, Bakke M, Kirkeby S et al (1990) Facial growth and oral function in a cases of juvenile rheumatoid arthritis during an 8-year period. Eur J Orthod 12:119–134

    PubMed  Google Scholar 

  24. Küseler A, Pedersen TK, Gelineck J, Herlin T (2005) A 2 year follow up study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol 32:162–169

    PubMed  Google Scholar 

  25. Larheim TA, Haanaes HR (1981) Micrognathia, temporomandibular joint changes and dental occlusion in juvenile rheumatoid arthritis of adolescents and adults. Scand J Dent Res 89:329–338

    PubMed  Google Scholar 

  26. Larheim TA, Haanaes HR, Dale K (1981) Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis. Acta Radiol Diagn (Stockh) 22:495–504

    Google Scholar 

  27. Mandall NA, Gray R, O’Brien KD et al (2010) Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids. J Orthod 37:6–15

    Article  PubMed  Google Scholar 

  28. Melsen B, Bjerregård J, Bundgård M (1986) The effect of treatment with functional ap-pliances on a pathologic growth pattern of the condyle. Am J Orthod Dentofacial Orthop 90:503–512

    Article  PubMed  Google Scholar 

  29. Mericle PM, Wilson VK, Moore TL et al (1996) Effects of polyarticular and pauciarticular onset juvenile rheumatoid arthritis on facial and mandibular growth. J Rheumatol 23:159–165

    PubMed  Google Scholar 

  30. Odenrick L (1977) Potential micrognathia in children with juvenile rheumatoid arthritis. Trans Eur Orthod Soc:297–316

    Google Scholar 

  31. Olson L, Eckerdal O, Hallonsten AL et al (1991) Craniomandibular function in juvenile chronic arthritis. A clinical and radiographic study. Swed Dent J 15:71–83

    PubMed  Google Scholar 

  32. Pearson MH, Ronning O (1996) Lesions of the mandibular condyle in juvenile chronic arthritis. Br J Orthod 23:49–56

    PubMed  Google Scholar 

  33. Pedersen TK (1998) Clinical aspects of orthodontic treatment for children with juvenile chronic arthritis. Acta Odontol Scand 56:366–368

    Article  PubMed  Google Scholar 

  34. Pedersen TK, Grønhøj J, Melsen B et al (1995) Condylar condition and mandibular growth during early functional treatment of children with juvenile chronic arthritis. Eur J Orthod 17:385–394

    PubMed  Google Scholar 

  35. Pedersen TK, Jensen JJ, Melsen B et al (2001) Resorption of the temporomandibular condylar bone according to subtypes of juvenile chronic arthritis. J Rheumatol 28:2109–2115

    PubMed  Google Scholar 

  36. Ronchezel MV, Hilario MO, Goldenberg J et al (1995) Temporomandibular joint and mandibular alterations in patients with juvenile rheumatoid arthritis. J Rheumatol 22:1956–1961

    PubMed  Google Scholar 

  37. Schwarzer CL, Bumann A, Küster RM (1995) Frühe Kiefergelenkbefunde bei Kindern mit Juveniler Chronischer Arthritis auf der Grundlage manueller Untersuchungstechniken. Inf Orthod Kieferorthop 27:549–563

    Google Scholar 

  38. Sfondrini G, Schiavi A, Lalli A et al (1991) L’ATM in soggetti affetti da artitite reumatoide giovanile: analisi funzionale e cefalometrica. Mondo Ortod 16:287–297

    PubMed  Google Scholar 

  39. Sidiropoulou-Chatzigianni S, Papadopoulos MA, Kolokithas G (2001) Dentoskeletal morphology in children with juvenile idiopathic arthritis compared with healthy children. J Orthod 28:53–58

    Article  PubMed  Google Scholar 

  40. Stabrun A (1991) Impaired mandibular growth and micrognathic development in children with juvenile rheumatoid arthritis. A longitudinal study of lateral cephalographs. Eur J Orthod 13:423–434

    PubMed  Google Scholar 

  41. Stabrun AE, Larheim TA, Höyeraal HM et al (1988) Reduced mandibular dimensions and asymmetry in juvenile rheumatoid arthritis. Pathogenetic factors. Arthritis Rheum 31:602–611

    Article  PubMed  Google Scholar 

  42. Stoustrup P, Kristensen KD, Küseler A et al (2008) Reduced mandibular growth in experimental arthritis in the temporomandibular joint treated with intra-articular corticosteroid. Eur J Orthod 30:111–119

    Article  PubMed  Google Scholar 

  43. Tavakkoli-Jou M, Miller AJ, Kapila S (1999) Mandibulofacial adaptations in a juvenile animal model of temporomandibular joint arthritis. J Dent Res 78:1426–1435

    Article  PubMed  Google Scholar 

  44. Twilt M, Arends LR, Cate RT et al (2007) Incidence of temporomandibular involvement in juvenile idiopathic arthritis. Scand J Rheumatol 36(3):184–188

    Article  PubMed  Google Scholar 

  45. Twilt M, Mobers SM, Arends LR et al (2004) Temporomandibular involvement in juvenile idiopathic arthritis. J Rheumatol 31:1418–1422

    PubMed  Google Scholar 

  46. Twilt M, Schulten AJ, Nicolaas P et al (2006) Facioskeletal changes in children with juvenile idiopathic arthritis. Ann Rheum Dis 65:823–825

    Article  PubMed  Google Scholar 

  47. Twilt M, Schulten AJ, Prahl-Andersen B et al (2009) Long-term follow-up of craniofacial alterations in juvenile idiopathic arthritis. Angle Orthod 79:1057–1062

    Article  PubMed  Google Scholar 

  48. Bremen J von, Ruf S (2011) Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature. Orthod Craniofac Res 14:107–115

    Article  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Department of Orthodontics, Medical Center for Dental and Oral Medicine, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany

    J. von Bremen & S. Ruf

Authors
  1. J. von Bremen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Ruf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. von Bremen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von Bremen, J., Ruf, S. Juvenile idiopathic arthritis—and now?. J Orofac Orthop 73, 265–276 (2012). https://doi.org/10.1007/s00056-012-0091-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00056-012-0091-2

Keywords

Schlüsselwörter

Search

Navigation