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. 2021 Jan 7;8(1):33.
doi: 10.3390/children8010033.

Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study

Andrea Abate  1   2 , Davide Cavagnetto  1   2 , Francesca Maria Emilia Rusconi  1   2 , Paolo Cressoni  1   2 , Luca Esposito  1   2
Affiliations

Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study

Andrea Abate et al. Children (Basel). .

Abstract

Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients.

Methods: Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups.

Results: All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients.

Conclusions: Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion).

Keywords: juvenile idiopathic arthritis; maxillary hypoplasia; rapid maxillary expansion; temporomandibular joint arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Rapid Palatal expander banded on the second deciduous molars.
Figure 2
Figure 2
Cephalometric landmarks used in the present study. Definitions of the landmarks are presented in Table 1.
See this image and copyright information in PMC

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References

    1. Giancane G., Consolaro A., Lanni S., Davì S., Schiappapietra B., Ravelli A. Juvenile Idiopathic Arthritis: Diagnosis and Treatment. Rheumatol. Ther. 2016;3:187–207. doi: 10.1007/s40744-016-0040-4. - DOI - PMC - PubMed
    1. Ugolini A., Doldo T., Huanca Ghislanzoni L.T., Mapelli A., Giorgetti R., Sforza C., Fastuca R., Lorusso P., Lagravère M.O., Michelotti A., et al. Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial. Am. J. Orthod. Dentofac. Orthop. 2017;17:1–7. doi: 10.1016/j.ajodo.2014.09.014. - DOI
    1. von Bremen J., Ruf S. Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: A systematic review of the literature. Orthod. Craniofacial Res. 2011;14:107–115. doi: 10.1111/j.1601-6343.2011.01514.x. - DOI - PubMed
    1. Müller L., Kellenberger C.J., Cannizzaro E., Ettlin D., Schraner T., Bolt I.B., Peltomäki T., Saurenmann R.K. Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: A pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology. 2009 doi: 10.1093/rheumatology/kep068. - DOI - PMC - PubMed
    1. Maspero C., Cavagnetto D., Abate A., Cressoni P., Farronato M. Effects on the Facial Growth of Rapid Palatal Expansion in Growing Patients Affected by Juvenile Idiopathic Arthritis with Monolateral Involvement of the Temporomandibular Joints: A Case-Control Study on Posteroanterior and Lateral Cephalograms. J. Clin. Med. 2020;9:1159. doi: 10.3390/jcm9041159. - DOI - PMC - PubMed

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