Juvenile Idiopathic Arthritis and mandibular growth: 3D morphologic and volumetric changes

AIM: The aim of this study is to show the importance of Cone Beam Computerized Tomography to volumetrically quantify TMJ damage in patients with Juvenile Idiopathic Arthritis (JIA), measuring condylar and mandibular real volumes, after therapy too. MATERIALS AND METHODS: 80 JIA children and 30 healthy children with temporomandibular involvement were observed by Cone Beam Computerized Tomography (CBCT). The mandible was isolated from others craniofacial structures; the whole mandibular volume and its components’ volumes (condyle, ramus, emibody, emisymphysis on right side and on left side) has been calculated by a 3D volume rendering technique. RESULTS: The results show a highly significant statistical difference between affected side volumetric values versus normal side volumetric values above all on condyle region (P<0.01), while they doesn’t show any statistical differences between right side versus left side. There is a high correlation between affected side condylar volume and growth (r = 0.9). Lower is condylar volume and lower is mandible growth. CONCLUSIONS: The CBCT represents a huge improvement in understanding of the condyle and mandibular morphological changes, even in the early stages of the Juvenile Idiopathic Arthritis. Early initiation and optimal adjustment of aggressive therapy with disease-modifying anti-rheumatic drugs have been extremely successful in preventing irreversible joint damage. Therefore, the accurate and early diagnosis of JIA and the sensitive monitoring of the disease process are essential. Advanced imaging technology capable of identifying even the slightest trace of erosive joint damage may enable the prediction of future structural and functional deterioration.