Root resorption in a patient with Juvenile Idiophatic Arthritis

Aim: To use possible root resorption in upper incisors teeth in patients with functional device Transverse Sagittal Maxillary Expander (TSME). Material and Methods: JIA is a common disease of childhood. It causes joint inflammation, typically before 16 years of age. The cause of the illness is unknown, and it persists for at least 6 weeks. The reported prevalence of JIA is 0.07 to 4.01 per 1000 individuals. The most important manifestation of the disease is chronic synovitis with epithelial proliferation, resulting in increased synovial fluid production and pressure within the affected joint(s). Temporomandibular joint (TMJ) is affected in 75% of acute cases and in 69% of chronic cases at the time of diagnosis. When the TMJ is affected, there is often no pain, which delays the diagnosis and treatment. Inflammation of the TMJ leads to bone resorption affecting the condyle head and fossa. The condylar abnormalities can range from slight erosion and flattening of the articular surfaces to severe destruction of the condyle head. The study was conducted on 81 patients, aged between 7 and 16 years, including 5 with Juvenile Idiopathic Arthritis (JIA) and 76 healthy subjects, all receiving TSME. TSME therapy was followed by all patients on a regular basis. Panoramic radiographs of the beginning of treatment were compared with Cone Beam CT of the end of treatment. Results: We found a single case of rhizolysis as in upper central incisors as in lateral incisors in a patient suffering from juvenile rheumatoid arthritis treated with MTX. TSME therapy was followed for 10 months. In this time, in the first week the trasversal expansion was 3.5mm long, with ½ turn per die. In the other time the therapy continued with the sagittal expansion. The remainder of the patients didn’t show signs of root resorption. Conclusions: Considering the totality of patients treated with TSME, it was evidenced that can be found in 1,25% of cases rhizolysis. But if we take into account only patients with JIA, the percentage would be 20%. It remains to be seen whether really exist a link between the treatment put in place and the presence of the disease, assessing a greater group of JIA patient.