title: Pathological changes in the TMJ and the length of the ramus in patients with confirmed juvenile idiopathic arthritis.
abstract: BACKGROUND
  Juvenile idiopathic arthritis (JIA) is characterized by a progressive destruction of the joints. The temporomandibular joints (TMJ) are especially likely to be affected. The often undetected arthritis in the TMJ in particular can cause significant destruction and craniofacial developmental abnormalities. The aim of this study was to analyze the destructive impact of JIA on TMJ and mandibular development.
  
  
  METHODS
  We analyzed a total of 92 joints and mandibular rami using digital cone-beam tomography (CBT) and compared 23 consecutively treated JIA patients with 23 healthy controls, matched for age and gender. We evaluated ramus length, vertical depth of the articular fossa, anterior-posterior dimensions of the mandibular head and condylar process. The statistical analysis was performed using non-parametric Wilcoxon and Kruskal-Wallis Rank Sum tests.
  
  
  RESULTS
  The JIA patients exhibited significantly more pronounced asymmetries. However, we were unable to detect significant differences in the metric measuring distances. The different JIA subtypes exerted no statistically significant influence.
  
  
  CONCLUSIONS
  The possible destruction arising as a result of JIA concerns the TMJ and the length of the mandibular ramus. These craniofacial anomalies demonstrate the central importance of sufficiently early detection and timely treatment in the prevention of such growth disturbances.
authors.affiliation: Department of Orthodontics, University Hospital of Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus 26, 24105 Kiel, Germany. Electronic address: koos-b@kfo-zmk.uni-kiel.de.
authors.forename: B
authors.initials: B
authors.lastname: Koos
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Gassling
authors.affiliation: Department of Orthodontics, University of Tübingen, Tübingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Bott
authors.affiliation: Pediatric Research Institute Bad Bramstedt, Bad Bramstedt, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Tzaribachev
authors.affiliation: Department of Oral Radiology, University of Tübingen, Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Godt
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000379:methods; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008445:Maxillofacial Development / Q000502:physiology; D013701:Temporal Bone / Q000000981:diagnostic imaging; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*
keywords: Cone beam tomography; Facial asymmetry; Growth disturbances; JIA; TMJ arthritis; Temporomandibular joint