Jaw surgery for correction of dentofacial anomalies caused by JIA

In a number of patients with juvenile idiopathic arthritis with involvement of the temporomandibular joint, a growth disturbance of the mandible and consequently the facial skeleton will occur. If orthopedic and orthodontic treatment cannot provide a sufficient normalization of the jaw relations and occlusion, a surgical treatment can be indicated. The aim of the surgical treatment is to relieve or prevent functional symptoms, provide an improvement of the facial morphology, and, if possible, normalize the masticatory function. A variety of surgical treatment principles can be applied to these patients, and in this article, we describe the various options and the rationale for their use. In particular, the timing of treatment is important to obtain optimal and predictable results. Conventional osteotomy techniques as well as distraction osteogenesis can be used in these treatments. It is essential to initiate early, long-term planning and involve the patient and his/her parents in the treatment options and the possible complications and relapse related to these.