Veränderungen der kraniofazialen Morphologie bei juveniler idiopathischer Arthritis – eine Literaturübersicht^[*]

Zusammenfassung

Ziel:

Ziel dieser Literaturübersicht war es, den Einfluss der Juvenilen Idiopathischen Arthritis (JIA) auf die kraniofaziale Gesichtsschädelmorphologie systematisch zu untersuchen.

Material und Methoden:

Mehrere elektronische Datenbanken (PubMed, Medpilot, Web of Science, DIMDI) sowie die kieferorthopädische und rheumatologische Fachliteratur wurde entsprechend der PRISMA-Richtlinien systematisch nach Studien durchsucht, die Hinweise auf die kraniofaziale Morphologie bei JIA-Kindern geben. Die ermittelten Artikel wurden unabhängig von 2 Untersuchern bewertet und nach einem 3-schrittigen Verfahren (Titel – Abstract – Volltext) ausgewählt.

Ergebnisse:

Nach Abschluss des Auswahlverfahrens standen 19 Artikel zur Verfügung, welche sich durch eine hohe Heterogenität auszeichneten. Im Großteil der Untersuchungen wurde keine differenzierte Analyse der verschiedenen JIA-Subtypen durchgeführt und auch eine differenzierte Auswertung nach Kiefergelenksbefall erfolgte selten. Auch weitere Angaben (Alter der Patienten, Erkrankungsdauer, Medikation, kieferorthopädische Vorbehandlung) sowie eine geeignete Kontrollgruppe waren in höchstem Maße uneinheitlich, was eine Metaanalyse der Daten nicht möglich machte. Es scheint jedoch, als sei die Kieferlagebeziehung bei JIA-Patienten in Richtung einer skelettalen Klasse II sowie einer hyperdivergenten Kieferrelation verändert.

Schlussfolgerung:

Somit ist derzeit aufgrund des inhomogenen Patientengutes keine differenzierte Aussage zum Einfluss verschiedener JIA-Arten auf die kraniofaziale Morphologie möglich.

Abstract

Aim:

The aim of this systematic literature review was to analyze the influence of Juvenile Idiopathic Arthritis (JIA) on the craniofacial morphology.

Material and methods:

According to the PRISMA guidelines, several electronic databases (PubMed, Medpilot, Web of Science, DIMDI) as well as the orthodontic and rheumatologic literature were systematically searched for studies describing the influence of JIA on the craniofacial morphology. The articles were screened and selected by 2 reviewers in a 3-step-procedure (title – abstract – full text).

Results:

19 articles, characterized by a great heterogeneity, were selected. In the majority of the papers there was no differentiation according to JIA-subtypes or temporomandibular joint involvement. Furthermore, the general necessary information (patient age, duration of JIA, general medication, orthodontic treatment, control group) was very inhomogeneous or lacking completely. Thus, it was not possible to perform a meta-analysis of the data. However, it seems, as if JIA-patients tend to develop a skeletal Class II as well as a hyperdivergent jaw base relation.

Conclusion:

Due to the very inhomogeneous patient samples, it is momentarily not possible to draw any differentiated conclusions on the influence of JIA on the craniofacial morphology of the affected patients.

Schlüsselwörter

Juvenile Idiopathische ­Arthritis (JIA) - kraniofaziale Morphologie

Key words

Juvenile Idiopathic Arthritis (JIA) - craniofacial morphology

^* Diese Übersichtsarbeit beruht auf den Ergebnissen einer systematischen Literaturrecherche, erschienen in: J Orofac Orthop 2012; 73: 265–276.

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