EFFECTS OF SYSTEMIC-ONSET JUVENILE RHEUMATOID-ARTHRITIS ON FACIAL MORPHOLOGY AND TEMPOROMANDIBULAR-JOINT FORM AND FUNCTION

Objective. Twenty-four patients with systemic onset juvenile rheumatoi d arthritis (JRA) were evaluated to determine its effects on facial mo rphology and temporomandibular joint (TMJ) form and function. Methods. Patients were evaluated with medical and dental histories, facial pho tographs, intraoral examination, TMJ examination, lateral tomograms or panoramic radiographs, cephalograms, and impressions for study models . The craniomandibular index (CMI) was used to quantitate mandibular m ovement, tenderness, and TMJ noise. Symptoms were measured by symptom severity index (SSI). CMI data from the patients with JRA were compare d to a, group of 24 children without JRA with similar mean age and sex distribution. Results. Our study indicates the facial morphology of p atients with systemic onset JRA is similar to that of healthy children except for a mild convex facial profile and backward rotation of the mandible. Changes in facial form were associated with radiographic con dylar abnormalities, CMI scores and SSI scores of systemic onset patie nts were significantly greater than controls, and radiographic condyla r changes were noted in 29.2% of the patients with systemic onset JRA. Conclusion. Our study suggests that systemic onset JRA significantly affects TMJ form and function. Facial form was only affected in the fe w patients with significant radiographic condylar changes.