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Mandibular distraction osteogenesis in patients with unilateral TMJ involvement in juvenile idiopathic arthritis

Authors
Journal
Pediatric Rheumatology
1546-0096
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
9
Identifiers
DOI: 10.1186/1546-0096-9-s1-p177
Keywords
  • Poster Presentation

Abstract

Mandibular distraction osteogenesis in patients with unilateral TMJ involvement in juvenile idiopathic arthritis POSTER PRESENTATION Open Access Mandibular distraction osteogenesis in patients with unilateral TMJ involvement in juvenile idiopathic arthritis SE Nørholt1*, TK Pedersen2, T Herlin3 From 18th Pediatric Rheumatology European Society (PReS) Congress Bruges, Belgium. 14-18 September 2011 Background In juvenile idiopathic arthritis (JIA) the temporomandib- ular joint is frequently involved which may result in severe growth impairment of the mandible. In cases of unilateral involvement growth impairment will result in an asymmetric lower face. Aim To evaluate long-term effect of distraction osteogenesis (DO) in JIA patients with unilateral TMJ in a prospec- tive study. Methods Twenty-three patients with JIA (mean age 16 y (11-34) underwent unilateral DO. Patients were treated accord- ing to standardized protocol: preoperative orthodontic planning, cephalometric analysis calculating distraction vector, and transfer of vector to the surgical procedure. An occlusal splint was used full-time. Data were ascer- tained before DO, after removal of distraction device, 6 and 12 months after DO, and at latest follow-up visit. Frontal cephalograms and orthopantomograms were performed comparing normal and affected side. Results TMJ function was within normal ranges before DO and with no significant changes after in all except two patients. Pain related to TMJ loading as a result of arthritis was reduced after treatment (5 before, none after). Mandibular asymmetry was corrected, relaxed lip closure was improved and respiratory pattern normal- ized. Tongue dysfunction was present in eight patients before treatment and in two patients at follow-up. Den- tal occlusion was normalized for all but two patients. Before treatment the maximum jaw opening was 47.6 mm with normal laterotrusion and protrusion. Shortly after DO mandibular mobility was significantly reduced but during follow-

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