title: 3D evaluation of mandibular skeletal changes in juvenile arthritis patients treated with a distraction splint: A retrospective follow-up.
abstract: OBJECTIVE
  To evaluate three-dimensional (3D) condylar and mandibular growth in patients with juvenile idiopathic arthritis (JIA) with unilateral temporomandibular joint involvement treated with a distraction splint.
  
  
  METHODS
  Cone-beam computed tomography (CBCT) scans were taken for 16 patients with JIA with unilateral TMJ involvement before treatment (T0) and 2 years after treatment (T1). All patients received orthopedic treatment with a distraction splint. Eleven patients without JIA who were undergoing orthodontic treatment without a functional appliance or Class II mechanics and who had taken CBCT scans before and after treatment, served as controls. Reconstructed 3D models of the mandibles at T0 and T1 were superimposed on stable structures. Intra- and intergroup growth differences in condylar and mandibular ramus modifications and growth vector direction of the mandibular ramus were evaluated.
  
  
  RESULTS
  In all patients with JIA there were asymmetric condylar volume, distal and vertical condylar displacement, and ramus length differences that were smaller on the affected side. Condylar displacement was more distal and less vertical in the JIA group than in the control group. A larger distal growth of the condylar head and a more medial rotation of the ramus on the affected side were found in the JIA group.
  
  
  CONCLUSIONS
  The orthopedic functional treatment for patients with JIA allows for condylar adaptation and modeling, thereby hindering, although with a widely variable response, a further worsening of the asymmetry. Unilateral affection has a possible influence on the growth of the nonaffected side.
authors.affiliation: a  PhD student, Centro Singular de Investigación en Tecnoloxías da Información (CITIUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Maria Florinda Otero
authors.initials: MF
authors.lastname: González
authors.affiliation: b  Professor, Section of Orthodontics, Institute of Odontology, Aarhus University and Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Thomas Klit
authors.initials: TK
authors.lastname: Pedersen
authors.affiliation: c  Associate Professor, Section of Orthodontics, Institute of Odontology, Aarhus University, Aarhus, Denmark.
authors.forename: Michel
authors.initials: M
authors.lastname: Dalstra
authors.affiliation: d  Professor, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Herlin
authors.affiliation: e  Professor and Head, Department of Orthodontics and Pediatric Dentistry, University of Basel, Basel, Switzerland, and Visiting Professor, Section of Orthodontics, Institute of Odontology, Aarhus University, Aarhus, Denmark.
authors.forename: Carlalberta
authors.initials: C
authors.lastname: Verna
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible; D008335:Mandibular Condyle / Q000473:pathology*; D012189:Retrospective Studies; D013165:Splints; D013705:Temporomandibular Joint Disorders / Q000150:complications*
keywords: Asymmetry; CBCT; Distraction splint; Juvenile arthritis; Mandible