Abstract：
BACKGROUND: Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joint (TMJ), which can alter mandibular growth and development and result in dentofacial deformities.
OBJECTIVE: To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity.
METHODS: The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal-Wallis test.
RESULTS: Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1.
CONCLUSIONS: The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
OBJECTIVE: To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity.
METHODS: The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal-Wallis test.
RESULTS: Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1.
CONCLUSIONS: The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
摘要：
背景：幼年特发性关节炎（JIA）经常影响颞下颌关节（TMJ），可以改变下颌骨的生长和发育，并导致牙面畸形。
目的：评估JIA相关牙颌面畸形患者应用牵张夹板（DS）矫形治疗的效果。
方法：回顾性研究包括30例JIA和单侧TMJ受累患者，另一组20例JIA和双侧TMJ受累患者，对照组为18名非JIA正畸患者，患有II类和III类错牙合。纳入标准为治疗前（T0）和治疗后2年（T1）的DS治疗和锥形束计算机断层扫描（CBCT）扫描。根据经过验证的基于CBCT的三维形态分析评估牙面形态和畸形。在T0和T1比较结果测量的组间差异，并使用Kruskal-Wallis检验评估T0和T1之间的组内变化。
结果：T0时的初步评估显示，单侧和双侧JIA组与对照组之间在八个牙面畸形变量中有三个存在显着差异：下颌后高度的两侧差异，下颌轴角，和后/前面部高度（比率）。在随访(T1)时，仅在下颌后高度方面观察到显著的组间差异,表明夹板治疗后组间差异不太明显.评估T0和T1之间的组间变化表明，除了后/前面部高度比之外，所有参数都保持不变。在T0和T1之间显著降低。
结论：研究结果表明，对于JIA和单侧或双侧TMJ受累的患者，DS治疗的潜力通常支持正常的牙面生长或至少限制牙面畸形的进一步恶化。
目的：评估JIA相关牙颌面畸形患者应用牵张夹板（DS）矫形治疗的效果。
方法：回顾性研究包括30例JIA和单侧TMJ受累患者，另一组20例JIA和双侧TMJ受累患者，对照组为18名非JIA正畸患者，患有II类和III类错牙合。纳入标准为治疗前（T0）和治疗后2年（T1）的DS治疗和锥形束计算机断层扫描（CBCT）扫描。根据经过验证的基于CBCT的三维形态分析评估牙面形态和畸形。在T0和T1比较结果测量的组间差异，并使用Kruskal-Wallis检验评估T0和T1之间的组内变化。
结果：T0时的初步评估显示，单侧和双侧JIA组与对照组之间在八个牙面畸形变量中有三个存在显着差异：下颌后高度的两侧差异，下颌轴角，和后/前面部高度（比率）。在随访(T1)时，仅在下颌后高度方面观察到显著的组间差异,表明夹板治疗后组间差异不太明显.评估T0和T1之间的组间变化表明，除了后/前面部高度比之外，所有参数都保持不变。在T0和T1之间显著降低。
结论：研究结果表明，对于JIA和单侧或双侧TMJ受累的患者，DS治疗的潜力通常支持正常的牙面生长或至少限制牙面畸形的进一步恶化。
