open access publication

Article, 2024

Long-term follow-up of corrective jaw surgery including distraction osteogenesis in 32 patients with juvenile idiopathic arthritis

International Journal of Oral and Maxillofacial Surgery, ISSN 1399-0020, 0901-5027, 10.1016/j.ijom.2024.06.001

Contributors

Krarup, H. (Corresponding author) [1] Pedersen, Thomas Klit [1] [2] Frid, Paula Hanna Therese [3] [4] [5] Nørholt, Sven Erik 0000-0003-2664-3787 [1] [2]

Affiliations

  1. [1] Aarhus University Hospital
    2. [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] Aarhus University
    3. [NORA names: AU Aarhus University; University; Denmark; Europe, EU; Nordic; OECD];
  3. [3] Public Dental Service Competence Centre of North Norway, Tromsø, Norway
    4. [NORA names: Miscellaneous; Norway; Europe, Non-EU; Nordic; OECD];
  4. [4] UiT The Arctic University of Norway
    5. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  5. [5] University Hospital of North Norway
    6. [NORA names: Norway; Europe, Non-EU; Nordic; OECD]

Abstract

Dentofacial deformity following juvenile idiopathic arthritis (JIA) with temporomandibular joint (TMJ) involvement is associated with functional, aesthetic, and psychosocial impairment. Corrective surgical treatment includes combinations of orthognathic surgeries (OS). The aims of this study were to assess orofacial symptoms, functional and aesthetic status, and stability after OS including mandibular distraction osteogenesis (MDO). A prospective study was conducted of 32 patients with JIA of the TMJ and dentofacial deformities who underwent MDO as the only surgery or in combination with bilateral sagittal split osteotomy, Le Fort I, and/or genioplastybetween 2003 and 2018. Data from clinical examinations and cephalograms performed pre- and postoperative and at long-term (mean 4 years) were analysed. Patients experienced unchanged orofacial symptoms (all P > 0.05), short-term TMJ functional impairment (all P < 0.001), and long-term morphological improvements in SNB angle (P < 0.001), anterior facial height (P < 0.001), mandibular length (P = 0.049), overjet (P < 0.001 and P = 0.005), and posterior facial symmetry (P = 0.046). MDO as the only surgery or with secondary adjunctive OS improved dentofacial morphology in terms of mandibular advancement, anterior facial height, posterior facial symmetry, and incisal relationships without long-term deterioration in TMJ function or orofacial symptoms.

Keywords

Le Fort I, SNB, SNB angle, advances, aesthetic status, angle, anterior facial height, arthritis, bilateral sagittal split osteotomy, cephalograms, clinical examination, combination, combination of orthognathic surgery, correct surgical treatment, corrective jaw surgery, data, deformation, dentofacial deformities, dentofacial morphology, deterioration, distraction, distraction osteogenesis, examination, facial height, facial symmetry, function, functional impairment, height, idiopathic arthritis, impairment, improvement, incisal relationship, incision, involvement, jaw surgery, joints, juvenile idiopathic arthritis, length, long-term, long-term deterioration, long-term follow-up, mandibular advancement, mandibular distraction osteogenesis, mandibular length, morphological improvement, morphology, orofacial symptoms, orthognathic surgery, osteogenesis, osteotomy, overjet, patients, pre-, prospective study, psychosocial impairment, relationship, sagittal split osteotomy, split osteotomy, stability, status, study, surgery, surgical treatment, symmetry, symptoms, temporomandibular joint, temporomandibular joint function, treatment

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