title: Condylar asymmetry in patients with juvenile idiopathic arthritis: Could it be a sign of a possible temporomandibular joints involvement?
abstract: OBJECTIVE
  The aim of the study was to evaluate the condylar and ramal asymmetry of the mandible in patients with juvenile idiopathic arthritis (JIA) using orthopantomographies (OPTs).
  
  
  METHODS
  A total of 30 JIA patients with confirmed diagnosis of JIA and a routine OPT, seeking for orthodontic therapy, free of specific symptoms of temporomandibular joint involvement, and 30 normal matched subjects with OPT were comprised in the study. The method of Habets et al. was used to compare the condyles and rami in OPT. The significance of between-group differences were assessed using Mann-Whitney test.
  
  
  RESULTS
  The results showed a high significant difference in the range of asymmetry of the condyle, being the patient group highly asymmetrical (P < 0.0001). No differences were found in the range of asymmetry of the ramus between groups (P = 0.47). The intra-group comparison between males and females showed a difference in the patient group (P = 0.04), being the females more asymmetric.
  
  
  CONCLUSIONS
  Knowing that the temporomandibular joint (TMJ) is highly susceptible to inflammatory alterations during growth, even in absence of symptomatology, and being the OPT a cost-benefit favorable imaging tool widespread in the dental field, the latter could be used as a first screening examination in JIA patients to calculate the condylar asymmetry index. The use of this screening tool will help the physicians in addressing the patients that should undergo a more detailed TMJ imaging to early detect TMJ abnormalities and to early set up a targeted therapy of the related cranial growth alterations.
authors.affiliation: Orthodontic division, Department of Surgical Sciences, PhD School, C.I.R. Dental School, University of Turin, Turin, Italy. Electronic address: mpianci@gmail.com.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Piancino
authors.affiliation: Orthodontic division, Department of Surgical Sciences, PhD School, C.I.R. Dental School, University of Turin, Turin, Italy.
authors.forename: Rosangela
authors.initials: R
authors.lastname: Cannavale
authors.affiliation: Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dalmasso
authors.affiliation: Orthodontic Division, Dental School, University of Brescia, Brescia, Italy.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tonni
authors.affiliation: Medical School, University of Turin, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Filipello
authors.affiliation: Department of Surgical and Dental Specialties, Second University of Naples, Naples, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Perillo
authors.affiliation: Pediatric Immunology and Reumatology Unit, University of Brescia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cattalini
authors.affiliation: Pediatric Immunology and Reumatology Unit, University of Brescia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Meini
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging*; D010808:Physical Examination; D011859:Radiography; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*
keywords: Asymmetry index; Early diagnosis; Juvenile idiopathic arthritis (JIA); Orthopantomography (OPT)