Craniofacial growth in children affected by juvenile idiopathic arthritis involving the temporomandibular joint : functional therapy management

The aim of this study was twofold: 1) to asses the effects of a functional appliance on condyles damaged by juvenile idiopathic arthritis (M). and 2) to evaluate its ability to reduce alterations in craniofacial development. Study design: Seventy-two JIA patients with temporomandibular involvement, ages ranging between 4 and 16 years, were treated. All of them presented temporomandibular joint involvement. They were treated with an activator and followed for 4 years. Results: At the second examination, it was possible to observe a reduction in mandibular retrusion and in the sagittal discrepancy between mandible and maxilla, a reduction in the angle of divergence, a counterclockwise rotation of the mandible, a reduction of the gonial angle, a longer mandibular ramus, a reduction in the discrepancy between anterior and posterior height caused by an increase in posterior height and a forward positioning of the chin. Conclusion: The functional appliance reduces the severity of facial alterations improving mandibular and condylar growth.