Mandibular Growth and Dental Occlusion in Juvenile Rheumatoid Arthritis

Summary and ConclusionsThe effect of juvenile rheumatoid arthritis on mandibular growth and the dental occlusion in nineteen patients at the Hospital for Rheumatic Diseases of the Oslo Women's Health Association were examined. When the tmj is involved insufficient condylar growth with subsequent reduction in the forward and downward displacement of the lower jaw is frequently seen.The growth deficiency is especially marked when the tmj is affected in the first years of life.Most cases reveal a posterior rotation of the lower jaw, with a short ascending ramus, an obtuse angle between the mandibular body and the ascending ramus, a moderate vertical height of the alveolar process in the molar region and a pronounced vertical height in the incisor region. A short and distally directed condylar neck is occasionally found.Subsequent changes in the dental occlusion are a tendency toward distocclusion and an anterior open bite.The micrognathia causes a decreased tongue space which is partly compensated for by an anterior position of the mandible in the rest position. (Roentgenologically an anterior position of the condyles is seen in these cases.) Protrusion of the incisors and a wide dental arch in the lower jaw are other clinical findings confirming this observation.Prolonged cortico-steroid therapy seems to be detrimental to condylar growth and normal mandibular development.