Mandibular osteotomies in patients with juvenile rheumatoid arthritic disease

Objective: This retrospective study evaluates the results after orthognathic surgery in a group of patients with juvenile rheumatoid arthritis. Methods: The material comprised sixteen patients where genioplasty with or without bilateral sagittal split (BSSO) had been performed during a 10-year period between 1991 and 2000. The patients were recalled for follow-up examination and the clinical records and radiographs of the patients were analysed. Results: All patients reported an improved facial esthetics. Sixty-two% reported altered neurosensory dysfunction in the inferior alveolar nerve, but no patients reported altered feelings to interfere with function. Two patients reported reduction in pain in the TMJ from a score 10 and 7 in the VAS-scale preoperatively, to 0 after the orthognathic surgery. Eight of the patients reported this to be less uncomfortable compared to other surgical procedures because of their JRA. Ninety-four% noted a positive social change after the operation. Conclusion: Orthognathic surgical treatment of the JRA patient improves the facial profile. The described procedures are safe and serious complications were not seen in our study.