Juvenile Idiopathic Arthritis : condylar and mandibular thee-dimensional morphologic and volumetric changes

Aim: To show the importance of Cone Beam Computerized Tomography (CBCT) to volumetrically quantify temporomandibular joint (TMJ) damage in patients with Juvenile Idiopathic Arthritis (JIA), by measuring condylar and mandibular real volumes. Materials and Methods: CBCT of 30 children with temporomandibular involvement by JIA. The mandible was isolated from others craniofacial structures and whole mandibular volume and its component volumes (condyle, ramus, emibody, emisymphysis on right side and on left side) were calculated using a three-dimensional volume rendering technique. Results: There was a highly significant statistical difference between volumetric values of the affected and normal sides, especially in the condylar region (P<0.01). The was no significant difference between the right and left sides. Conclusions: CBCT represents an improvement in the understanding of condyle and mandibular morphological changes, even in the early stages of the JIA. Early initiation and optimal adjustment of aggressive therapy with disease-modifying anti-rheumatic drugs has been successful in preventing irreversible joint damage. Therefore, accurate and early diagnosis of JIA and monitoring of the disease process are essential. Advanced imaging technology capable of identifying the slightest trace of erosive joint damage may enable prediction of future structural and functional deterioration.