Mandibular growth, temporomandibular joint changes and dental occlusion in juvenile rheumatoid arthritis. A 17-year follow-up study.

To evaluate the mandibular growth and temporomandibular joint (TMJ) changes in juvenile rheumatoid arthritis, a clinical and radiographic 17-year re-examination of 9 of 19 patients has been carried out. A varying degree of micrognathia (mandibular retrognathia, 'bird face') was observed by means of radiographic cephalometric analysis, at both the base-line and follow-up examination of 6 of the patients. No facial asymmetry was found. Rotation of the mandible in relation to the anterior cranial base during the follow-up period, observed in 5 of the 6 patients, indicated a further disturbance of mandibular growth. In 3 patients with mandibular rotation, a dental occlusion anomaly was observed. The TMJ revealed radiographic changes in 6 patients at the base-line examination and in all patients at the re-examination. Micrognathia and the dental occlusion anomaly were associated with radiographic TMJ changes.