Craniofacial growth in juvenile chronic arthritis

The craniofacial growth in children with juvenile chronic arthritis (JCA), especially that of the mandible, and the degree of destruction of the mandi bular condyles vary depending on the heterogeneity in duration and intensit y of the disease. In JCA children showing destruction of the temporomandibu lar joint, the dentofacial morphology is characterized by overall smaller d imensions of the mandible, mandibular retrognathia, a steep mandibular plan e, Class II malocclusion, dental crowding, and frontal open bite. In childr en with unilateral condylar destruction, asymmetries will develop, with the chin deviating to the affected side. The facial morphology of JCA children with condylar lesions becomes more abnormal during growth, reflecting a de celerated mandibular development and a backward-rotating growth pattern. Th e main single cause of the deviating craniofacial growth is mandibular cond ylar destruction. Other factors that may influence the craniofacial growth are head posture, soft tissue stretching, disease activity and drug therapy , type of onset of the disease, muscle weakness, decreased functional abili ty, and orthodontic treatment.