Section of Orthodontics, Aarhus University, Aarhus, Denmark.
Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
Pediatr Rheumatol Online J. 2022 Apr 27;20(1):32. doi: 10.1186/s12969-022-00691-w.
This retrospective, cross-sectional study aimed to assess the pharyngeal airway dimensions of patients with juvenile idiopathic arthritis (JIA) and moderate/severe JIA-related dentofacial deformity (mandibular retrognathia/micrognathia), and compare the results with JIA patients with a normal mandibular appearance and a group of non-JIA patients.
Seventy-eight patients were retrospectively included in a 1:1:1 manner as specified below. All patients had previously been treated at the Section of Orthodontics, Aarhus University, Denmark. All had a pretreatment cone beam computed tomography (CBCT). Group 1 (JIA+); 26 JIA patients with severe arthritis-related dentofacial deformity and mandibular retrognathia/micrognathia. Group 2 (JIA-); 26 JIA patients with normal mandibular morphology/position. Group 3 (Controls); 26 non-JIA subjects. Dentofacial morphology and upper airway dimensions, excluding the nasal cavity, were assessed in a validated three-dimensional (3D) fashion. Assessment of dentofacial deformity comprised six morphometric measures. Assessment of airway dimensions comprised nine measures.
Five morphometric measures of dentofacial deformity were significantly deviating in the JIA+ group compared with the JIA- and control groups: Posterior mandibular height, anterior facial height, mandibular inclination, mandibular occlusal inclination, and mandibular sagittal position. Five of the airway measurements showed significant inter-group differences: JIA+ had a significantly smaller nasopharyngeal airway dimension (ad2-PNS), a smaller velopharyngeal volume, a smaller minimal cross-sectional area and a smaller minimal hydraulic diameter than JIA- and controls. No significant differences in upper airway dimensions were seen between JIA- and controls.
JIA patients with severe arthritis-related dentofacial deformity and mandibular micrognathia had significantly restricted upper airway dimensions compared with JIA patients without dentofacial deformity and controls. The restrictions of upper airway dimension seen in the JIA+ group herein were previously associated with sleep-disordered breathing in the non-JIA background population. Further studies are needed to elucidate the role of dentofacial deformity and restricted airways in the development of sleep-disordered breathing in JIA.
本回顾性、横断面研究旨在评估患有幼年特发性关节炎（JIA）和中度/重度 JIA 相关牙颌面畸形（下颌后缩/小下颌）的患者的咽腔气道尺寸，并将结果与 JIA 患者的正常下颌外观和一组非 JIA 患者进行比较。
以以下方式以 1:1:1 的方式回顾性纳入 78 名患者。所有患者均曾在丹麦奥胡斯大学正畸科接受治疗。所有患者均接受过治疗前锥形束计算机断层扫描（CBCT）检查。第 1 组（JIA+）：26 名 JIA 患者，严重关节炎相关牙颌面畸形，下颌后缩/小下颌。第 2 组（JIA-）：26 名 JIA 患者，下颌形态/位置正常。第 3 组（对照组）：26 名非 JIA 受试者。以验证的三维（3D）方式评估牙颌面形态和上气道尺寸，不包括鼻腔。牙颌面畸形的评估包括 6 项形态测量指标。气道尺寸的评估包括 9 项指标。
与 JIA-组和对照组相比，JIA+组的 5 项牙颌面畸形形态测量指标存在显著差异：下颌后高、前面部高度、下颌倾斜度、下颌咬合倾斜度和下颌矢状位置。气道测量的 5 项指标显示出显著的组间差异：JIA+组的鼻咽气道尺寸（ad2-PNS）、腭咽腔容积、最小横截面积和最小水力直径均明显小于 JIA-组和对照组。JIA-组和对照组之间的上气道尺寸无显著差异。
与无牙颌面畸形和对照组的 JIA 患者相比，患有严重关节炎相关牙颌面畸形和下颌小下颌的 JIA 患者的上气道尺寸明显受限。JIA+组中观察到的上气道尺寸受限与非 JIA 背景人群的睡眠呼吸障碍有关。需要进一步的研究来阐明牙颌面畸形和气道受限在 JIA 中睡眠呼吸障碍发展中的作用。
