Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids

(1) Background—The aim of the present study was to evaluate the correlation between the temporomandibular joint (TMJ) osseous morphology of normal skeletal pattern individuals with different dental malocclusions by using cone-beam computed tomography (CBCT). (2) Methods—The CBCT images of bilateral TMJs in 67 subjects with skeletal class I and average mandibular angle (26 males and 41 females, age range 20–49 years) were evaluated in this study. The subjects were divided into class I, class II division 1, and class II division 2 according to the molar relationship and retroclination of the maxillary incisors. Angular and linear measurements of TMJ were evaluated and the differences between the groups were statistically analyzed. (3) Results—Intragroup comparisons showed statistical differences for articular eminence inclination, the width of the glenoid fossa, the ratio of the width of the glenoid fossa to the depth of the glenoid fossa, the condylar angle, and the intercondylar angle between the malocclusion groups. The measurements of the glenoid fossa shape showed no significant difference between the left and right sides. Females showed more differences in the morphological parameters of TMJ between the three malocclusion groups than the males. (4) Conclusion—The present study revealed differences in the TMJ osseous morphology between dental class I and class II malocclusions in the normal skeletal pattern.

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Sagittal Split Ramus Osteotomy in the Shortest Buccal Bone Marrow Distances of the Mandible on the Coronal Plane

BioMed Research International ◽

10.1155/2021/5586498 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Chun-Ming Chen ◽

Han-Jen Hsu ◽

Ping-Ho Chen ◽

Shih-Wei Liang ◽

I-Ling Lin ◽

...

Keyword(s):

Bone Marrow ◽

Mandibular Canal ◽

Class Ii ◽

Coronal Plane ◽

Class Iii ◽

Sagittal Split Ramus Osteotomy ◽

Mandibular Foramen ◽

Skeletal Class ◽

Skeletal Pattern ◽

The Relationship

Purpose. This study investigated the relationship between the shortest buccal bone marrow of the ramus and skeletal patterns. Materials and Methods. Using cone-beam computed tomography data (specifically, the A point-nasion-B point (ANB) angle), we divided patients into three groups as follows: skeletal class I ( 0 ° < ANB < 4 ° ), class II (ANB: ≥4°), and class III (ANB: ≤0°). Sixteen vertical sections in the coronal plane were taken starting from slice 0 (original intact mandibular canal) anteriorly at 2 mm intervals to slice 15 (30 mm). The thickness of the mandible (M) and shortest buccal bone marrow (SBM) were measured. The data of SBM were divided into two groups ( SBM ≥ 1 mm and SBM < 1 mm ). For each skeletal pattern, an SBM value < 1 mm was considered to indicate a high possibility of postoperative nerve paresthesia and bad split. Results. The three skeletal pattern groups also did not significantly differ in their M values for all sections. The mean SBM values of class III (0.91–2.11 mm) at 6–16 mm anterior to the mandibular foramen were significantly smaller than those of class II (1.53–3.17 mm). Comparing the occurrence ratio of SBM < 1 mm , the highest and lowest probabilities in class III (55% and 21.7%, respectively) were significantly larger at 6–20 mm anterior to the mandibular foramen than those in class II (28.3% and 5%, respectively). Conclusion. Class III had a significantly shorter SBM distance and higher SBM occurrence probability than class II at the mandibular ramus region, implying that class III participants are more likely than class II participants to have nerve paresthesia and bad split after sagittal split ramus osteotomy.

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Evaluation of tongue posture & dimensions in relation to skeletal Class I and Class II patterns- A cephalometric study

International Journal of Oral Health Dentistry ◽

10.18231/j.ijohd.2021.054 ◽

2021 ◽

Vol 7 (4) ◽

pp. 276-281

Author(s):

Puja Khanna ◽

Sumit Chhabra ◽

Preeti Munjal ◽

Sunny Mittal ◽

Nishtha Arora

Keyword(s):

Statistical Tests ◽

Class Ii ◽

Class I ◽

Control Group ◽

Skeletal Class ◽

Normal Occlusion ◽

Division 1 ◽

Skeletal Pattern ◽

Bonferroni Test ◽

Class Ii Division 1

Association of tongue posture with dental and facial skeletal pattern have been suggested in past. This study was undertaken to assess tongue posture and dimensions in Class I and Class II Dentoskeletal patterns to determine whether any correlation exists between tongue posture and skeletal pattern of an individual. Cephalograms of 150 individuals (aged 18-23 years), taken in Natural Head Position (NHP) and tongue at rest were divided into three groups i.e. Group 1 – Class I Normal occlusion, Group 2 – Class II Division 1 Normodivergent and Group 3 – Class II Division 1 Hypodivergent, consisting of 50 samples each. To ensure the rest position of tongue, patient was asked to relax for 30 seconds after coating the tongue with barium sulphate in midline and then to swallow, and the X-ray was taken at the end of swallowing. Each group was divided into two subgroups according to sex. Groups were constituted according to the Frankfort mandibular plane angle (FMA) angle. The subjects who had skeletal Class II pattern due to mandibular retrusion and not due to maxillary prognathism were only included in the study group. Statistical analysis was done using the software SPSS version 21.0. The statistical tests used were unpaired t-test and One-way ANOVA test with post-hoc bonferroni test. The p-value was considered significant if less than 0.05.The dorsum of the tongue was higher at back and lower in front in Class II Division 1 Hypodivergent group as compared to Class I Normal occlusion group (P<.05). Tongue height and tongue length were significantly reduced in Class II Division 1 Normodivergent and Class II Division 1 Hypodivergent malocclusion groups when compared to Class I control group (P<.05).The study supports the existence of a relationship between posture & dimensions of the tongue with Class I and Class II skeletal patterns.

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Principles of management of juvenile idiopathic arthritis

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0096 ◽

2013 ◽

pp. 725-733 ◽

Cited By ~ 1

Author(s):

Nicolino Ruperto ◽

Angelo Ravelli

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Disease Control ◽

Physical Therapist ◽

Well Being ◽

Standards Of Care ◽

Pharmacological Interventions ◽

American College Of Rheumatology ◽

Systemic Corticosteroids ◽

Biologic Response ◽

Disease Modifying

The management of juvenile idiopathic arthritis (JIA) is based on a combination of pharmacological interventions, physical and occupational therapy, and psychosocial support. Ideally, the management is conducted by a multidisciplinary team composed by a paediatric rheumatologist, specialist nurse, physical therapist, occupational therapist, and psychologist. The treatment is aimed to achieve disease control, to relieve pain, to foster normal nutrition and growth, to maintain physical and psychological well-being, and to prevent long-term damage related to the disease or its therapy. First-line pharmacological interventions are based on non-steroidal anti-inflammatory drugs and intra-articular corticosteroids. Patients who are refractory to these therapies are candidates to receive disease-modifying anti-rheumatic medications, namely methotrexate or, in case of enthesitis-related arthritis, sulfasalazine. If therapeutic response is inadequate or suboptimal, the introduction of a biologic response modifier is considered. Systemic corticosteroids are used in selected instances, which include the management of extra-articular manifestations of systemic arthritis or the achievement of quick disease control while are awaiting the full therapeutic effect of a disease-modifying agent in patients with severe polyarthritis. To help physician select the safest and most effective treatment for JIA, the American College of Rheumatology (ACR) has issued a set of recommendations that were meant to be as evidence based as possible. The British Society for Paediatric and Adolescent Rheumatology (BSPAR) has developed the standards of care for patients with JIA, which are aimed to help the paediatric rheumatology teams to improve the service they provide.

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Relationship between skeletal Class II and Class III malocclusions with vertical skeletal pattern

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.24.4.063-072.oar ◽

2019 ◽

Vol 24 (4) ◽

pp. 63-72

Author(s):

Sonia Patricia Plaza ◽

Andreina Reimpell ◽

Jaime Silva ◽

Diana Montoya

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Class Iii ◽

Class Iii Malocclusion ◽

Multinomial Regression ◽

Lateral Cephalogram ◽

Cross Sectional ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Skeletal Pattern

ABSTRACT Objective: The purpose of this study was to establish the association between sagittal and vertical skeletal patterns and assess which cephalometric variables contribute to the possibility of developing skeletal Class II or Class III malocclusion. Methods: Cross-sectional study. The sample included pre-treatment lateral cephalogram radiographs from 548 subjects (325 female, 223 male) aged 18 to 66 years. Sagittal skeletal pattern was established by three different classification parameters (ANB angle, Wits and App-Bpp) and vertical skeletal pattern by SN-Mandibular plane angle. Cephalometric variables were measured using Dolphin software (Imaging and Management Solutions, Chatsworth, Calif, USA) by a previously calibrated operator. The statistical analysis was carried out with Chi-square test, ANOVA/Kruskal-Wallis test, and an ordinal multinomial regression model. Results: Evidence of association (p< 0.05) between sagittal and vertical skeletal patterns was found with a greater proportion of hyperdivergent skeletal pattern in Class II malocclusion using three parameters to assess the vertical pattern, and there was more prevalent hypodivergence in Class III malocclusion, considering ANB and App-Bpp measurements. Subjects with hyperdivergent skeletal pattern (odds ratio [OR]=1.85-3.65), maxillary prognathism (OR=2.67-24.88) and mandibular retrognathism (OR=2.57-22.65) had a significantly (p< 0.05) greater chance of developing skeletal Class II malocclusion. Meanwhile, subjects with maxillary retrognathism (OR=2.76-100.59) and mandibular prognathism (OR=5.92-21.50) had a significantly (p< 0.05) greater chance of developing skeletal Class III malocclusion. Conclusions: A relationship was found between Class II and Class III malocclusion with the vertical skeletal pattern. There is a tendency toward skeletal compensation with both vertical and sagittal malocclusions.

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Skeletal Changes during the Treatment of Class II/I Malocclusions

British Journal of Orthodontics ◽

10.1179/bjo.10.3.147 ◽

1983 ◽

Vol 10 (3) ◽

pp. 147-153 ◽

Cited By ~ 8

Author(s):

A. M. Cohen

Keyword(s):

Class Ii ◽

Skeletal Growth ◽

Skeletal Changes ◽

Skeletal Pattern ◽

Removable Appliance

Three groups of Class II/I patients were compared where treatment was carried out using Begg, Andresen and removable appliance techniques. Skeletal growth, as assessed by the dimensions S-Me, N-Me, ALFH and Me-Ar did not show any difference between the groups. All three groups showed an apparent improvement in skeletal pattern during treatment.

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Abatacept in the Treatment of Severe, Longstanding, and Refractory Uveitis Associated with Juvenile Idiopathic Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.140410 ◽

2015 ◽

Vol 42 (4) ◽

pp. 706-711 ◽

Cited By ~ 43

Author(s):

Christoph Tappeiner ◽

Elisabetta Miserocchi ◽

Bahram Bodaghi ◽

Kaisu Kotaniemi ◽

Friederike Mackensen ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Immunosuppressive Treatment ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Ocular Complications ◽

Systemic Corticosteroids ◽

Before And After ◽

Active Arthritis ◽

Factor Α ◽

Antigen Presenting

Objective.Abatacept (ABA), a selective T cell costimulation modulator that binds to CD80 and CD86 on antigen-presenting cells, was investigated for its antiinflammatory effect in treating severe chronic uveitis associated with juvenile idiopathic arthritis (JIA).Methods.Our retrospective study was conducted by members of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC). Patients with JIA who are receiving ABA treatment for active uveitis were included. In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, immunosuppressives, and at least 1 tumor necrosis factor–α inhibitor. A standardized protocol was used to document uveitis (MIWGUC) and arthritis. Baseline visit and visits at 3, 6, 9, and 12 months before and after ABA start were evaluated. Primary outcome measure was defined as achievement of uveitis inactivity; secondary outcome measures were tapering of corticosteroid and/or immunosuppressive treatment, and occurrence of complications.Results.In all, 21 patients (16 female) with active uveitis (n = 21) and arthritis (n = 18) were included (mean age 11.8 ± 3.6 yrs). In 7 of 18 patients with active arthritis at baseline, inactivity was achieved following ABA treatment. Uveitis inactivity was achieved in 11 patients, but recurred later in 8 of them, and remained active in another 10 cases. Systemic corticosteroids or immunosuppression were tapered in 3 patients, but uveitis recurred in all of them during further followup. Ocular complications secondary to uveitis were present in 17 patients at baseline, while 3 patients developed new ocular complications during followup.Conclusion.A sustained response to ABA was uncommon in patients with severe and refractory uveitis.

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Occlusal plane canting reduction accompanies mandibular counterclockwise rotation in camouflaging treatment of hyperdivergent skeletal Class II malocclusion

The Angle Orthodontist ◽

10.2319/101512-801.1 ◽

2013 ◽

Vol 83 (5) ◽

pp. 758-765 ◽

Cited By ~ 2

Author(s):

Rui Ye ◽

Yu Li ◽

Xue Li ◽

Juan Li ◽

Jue Wang ◽

...

Keyword(s):

Class Ii ◽

Occlusal Plane ◽

Maxillary Incisor ◽

Class Ii Malocclusion ◽

Clockwise Rotation ◽

Skeletal Class ◽

Counterclockwise Rotation ◽

Clinically Normal ◽

Skeletal Class Ii ◽

Skeletal Pattern

ABSTRACT Objective To investigate the occlusal configurations of the hyperdivergent skeletal Class II malocclusion and their alterations during the camouflaging treatment in an attempt to identify occlusal changes that might be related to mandibular counterclockwise rotation. Materials and Methods Cephalograms of 126 subjects with hyperdivergent skeletal Class II malocclusion and 126 subjects with a clinically normal skeletal pattern were chosen. Several measurements were calculated and compared between the groups. To examine the effects of treatment, two groups were established according to mandibular rotation: counterclockwise rotation (CCR) and the opposite clockwise rotation (CR). After 40 subjects were excluded, the other 86 Class II subjects were assigned to CCR (n = 22) and CR (n = 64). Their pretreatment (T1), posttreatment (T2), and postretention (T3) cephalograms were obtained. Measurement changes (T3-T1) were analyzed in each group and compared between groups. Results Compared with the normal skeletal pattern, the cant of the occlusal plane (OP) of the study subjects was significantly steeper and the vertical heights of the incisors were significantly larger for the malocclusion. Compared with the changes in CR, there was a prominent reduction of the OP canting with remarkable intrusion of the maxillary incisor in CCR. Conclusion Increased OP canting with overerupted incisors is evident in the hyperdivergent skeletal Class II malocclusion. During the camouflaging treatment, reduction of OP canting could occur. It was accompanied by mandibular counterclockwise rotation and intrusion of the maxillary incisor.

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220-P: Examination of HLA class II amino acid variation in juvenile idiopathic arthritis (JIA) implicates P4 with position 86

Human Immunology ◽

10.1016/j.humimm.2009.09.253 ◽

2009 ◽

Vol 70 ◽

pp. S123

Author(s):

Jill Hollenbach ◽

Teodorica Bugawan ◽

Marc Sudman ◽

Glenys Thomson ◽

Susan Thompson ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Amino Acid ◽

Class Ii ◽

Hla Class Ii ◽

Amino Acid Variation

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RELATIONSHIP BETWEEN OCCLUSAL PLANE ORIENTATION AND SAGITTAL MALOCCLUSIONS: STUDY OF AN ORTHODONTIC POPULATION

Innovare Journal of Social Sciences ◽

10.22159/ijss.2021.v9i3.41058 ◽

2021 ◽

pp. 1-6

Author(s):

INES DALLEL ◽

SANA KANOUN ◽

MARIEM NAHDI ◽

MONCEF OMMEZINE ◽

SAMIR TOBJI ◽

...

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Significant Rise ◽

Class I ◽

Occlusal Plane ◽

Class Iii ◽

Angle Class ◽

Mandibular Plane ◽

Significant Difference ◽

Skeletal Pattern

Objective: The aim of this study was to evaluate the association of the skeletal pattern and angle class with the occlusal plane (OP). This study also examined the effect of orthodontic treatment on this plane. Methods: Lateral cephalometric radiographs of a sample of 135 patients were collected. The angles between the Frankfort horizontal, palatal plane (PP), mandibular plane (MP), and the OP were analyzed and compared between several groups and subsequently before and after treatment. Results: The statistical comparison between 3 skeletal frame groups demonstrates that the cant of the OP showed a major difference. This difference was greater in class III subjects. Examination revealed that the OP was not meaningfully affected within the Angle classification. Statistically, a significant correlation was found between OP steepness and the vertical skeletal pattern. A significant rise of OP/sella-nasion (SN) for class I (p=0.019) and II (p=0.015) after orthodontic treatment. In addition, patients treated with elastics showed a significant decrease of OP/MP (mandibular plane) in Angle class III and considerable increase of OP/SN and OP/PP in Angle class II. Observations of the group treated with bimaxillary extractions showed that OP/SN (sella nasion line) and OP/PP differ in a meaningful way. Conclusion: This study confirms the association between the skeletal pattern and the OP inclination in adults. Concerning the Angle classification, there was no significant difference between the groups. Orthodontic therapy had an influence on the inclination of this plane for the different malocclusions. Premolars extraction in class I cases significantly modified the OP. For class II and III malocclusions, the OP inclination was mainly altered by the use of intermaxillary traction elastics.

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