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Advisory Committee Chair

Chung How Kau

Advisory Committee Members

Randy Cron

Brian Kinard

Peter Waite

Document Type

Thesis

Date of Award

2021

Degree Name by School

Master of Science (MS) School of Dentistry

Abstract

Introduction: The temporomandibular joint (TMJ) is affected in 30-45%% of Juvenile Idiopathic Arthritis (JIA) patients, with all JIA subtypes at risk for TMJ involvement. JIA patients with TMJ involvement may present with altered craniofacial morphology, including micrognathia, mandibular retrognathia, a hyperdivergent mandibular plane angle, and skeletal anterior open bite. These features are also commonly present and associated with non-JIA pediatric patients with obstructive sleep apnea (OSA). Materials and Methods: The study comprised of a group of 32 JIA patients and a group of 32 healthy control subjects. CBCT images were taken for all patients and were imported into Dolphin Imaging software. Dolphin Imaging was used to measure the upper airway volumes and most constricted cross-sectional areas of each patient. Cephalometric images were rendered from the CBCT data for each patient and the following cephalometric values were identified: SNA angle, SNB angle, ANB angle, anterior facial height (AFH), posterior facial height (PFH), iii mandibular plane angle (SN-MP), FMA (FH-MP), overjet (OJ), overbite (OB). Airway volumes, most constricted cross-sectional area values, and cephalometric values were compared between the JIA and control groups. Results: For airway values, statistically significant differences were seen in the nasopharynx airway volume (p=0.004), total upper airway volume (p=0.013), and most constricted cross-sectional area (p=0.026). The oropharynx airway volume approached statistical significance (p=0.051). For cephalometric values, only the posterior facial height showed statistically significant difference (p=0.024). Conclusions: There is a significant difference in the nasopharynx airway volume, total upper airway volumes, and most constricted cross-sectional area of JIA patients compared to healthy controls. When comparing cephalometric values, only the posterior facial height was shown to be different between the groups.

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