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

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 in...

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Main Authors: Andrea Abate, Davide Cavagnetto, Francesca Maria Emilia Rusconi, Paolo Cressoni, Luca Esposito
Format: Article
Language:English
Published: MDPI AG 2021-01-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/8/1/33
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author Andrea Abate
Davide Cavagnetto
Francesca Maria Emilia Rusconi
Paolo Cressoni
Luca Esposito
author_facet Andrea Abate
Davide Cavagnetto
Francesca Maria Emilia Rusconi
Paolo Cressoni
Luca Esposito
author_sort Andrea Abate
collection DOAJ
description 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 <i>t</i>-test and Independent <i>t</i>-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).
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spelling doaj.art-9f03146fbc1d45ca8ac11023d9846b052023-12-03T12:22:24ZengMDPI AGChildren2227-90672021-01-01813310.3390/children8010033Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective StudyAndrea Abate0Davide Cavagnetto1Francesca Maria Emilia Rusconi2Paolo Cressoni3Luca Esposito4Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, ItalyDepartment of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, ItalyDepartment of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, ItalyDepartment of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, ItalyDepartment of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, ItalyBackground: 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 <i>t</i>-test and Independent <i>t</i>-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).https://www.mdpi.com/2227-9067/8/1/33juvenile idiopathic arthritistemporomandibular joint arthritismaxillary hypoplasiarapid maxillary expansion
spellingShingle Andrea Abate
Davide Cavagnetto
Francesca Maria Emilia Rusconi
Paolo Cressoni
Luca Esposito
Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
Children
juvenile idiopathic arthritis
temporomandibular joint arthritis
maxillary hypoplasia
rapid maxillary expansion
title Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
title_full Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
title_fullStr Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
title_full_unstemmed Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
title_short Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
title_sort safety and effects of the rapid maxillary expander on temporomandibular joint in subjects affected by juvenile idiopathic arthritis a retrospective study
topic juvenile idiopathic arthritis
temporomandibular joint arthritis
maxillary hypoplasia
rapid maxillary expansion
url https://www.mdpi.com/2227-9067/8/1/33
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