The orthodontist in the team-treatment for children with rheumatoid arthritis.

In 160 children with rheumatoid arthritis (RA) functional and morphological disorders of the stomatognathic system were found in 65 per cent of the group. The functional TMJ examination revealed the early involvement of these joints. The age of children, the insidious and irreversible damage of the TMJ development and its consequences, indicate the need for functional treatment of these joints and associated malocclusions. Thus the orthodontist's participation in the team-treatment of children with RA, from the early periods of the stomatognathic system development is necessary.

Results of epidemiological examinations of the temporomandibular joint in adolescents and young adults.

An epidemiological investigation of the temporomandibular joint in 800 persons was undertaken, including two groups of 400 persons aged 15-18 and 19-22 years. The numbers of boys and girls was about the same. Interview and clinical examination comprised morphological and functional features of the stomatognathic system. The TMJ examination carried out included mandibular movements, pain and sound symptoms. The results of the examinations were noted, counted by electronic methods and statistically analysed. From the material, two groups were selected: without TMJ symptoms (OTMJ group) and with TMJ disorders (TMJ group). TMJ disorders were evident in 67.62% of the examined persons and this was common to both age groups. In groups with TMJ disorders a significant incidence of girls was found. In groups with TMJ disorders the number of statistically significant pathological features in the stomatognathic system increased with age. TMJ disorders appeared in both age groups in various forms, separately or in combination, with different frequency. With reference to the number and kind of symptoms obtained on interview and/or on clinical examination, four degrees of intensity of TMJ disorders have been defined and their incidence discussed.

The temporomandibular joint in children after breech delivery.

In an effort to explain the aetiology of early temporomandibular joint (TMJ) injuries, their incidence in children born by vaginal breech delivery and possible correlation with such deliveries were investigated. The study covered 156 children aged from 4 to 6 years, eighty-three of them born by vaginal breech delivery under application of the classical Mauriceau manoeuvre in seventeen cases and the Bracht manoeuvre in sixty-six. Seventy-three children delivered spontaneously in vertex presentation served as the control group. Signs of TMJ injury were found in 59.6% of the total group, the by-birth percentages being 67.5 in those after breech delivery and 50.7 in those after spontaneous delivery--the difference is statistically significant. The difference was even more significant for the more severe TMJ disorders, their percentages being in two groups respectively 48.2 and 29.7. In the children born by breech delivery the TMJ disorders were invariably attended by severe forms of distocclusion, among which the unilateral form deserves particular attention. The authors conclude that vaginal breech delivery is probably among the factors responsible for early TMJ abnormalities. They call the attention of paediatricians and obstetricians to this fact and urge examination of this joint as a very important part of oral examination in children born by vaginal breech delivery.

Musculo-articular disorders of the stomatognathic system in school children examined according to clinical criteria.

The present investigations were undertaken for establishing the frequency of musculo-articular disorders of the stomatognathic system in healthy children as well as determining their features and degree. The study covered 500 children from Warsaw's primary schools--250 children aged 6-8 years and 250 aged 13-15 years. An incidence of disorder of 56-4 and 67-6% was found in the groups of younger and older children, respectively; their number and severity being significantly higher among the latter. The chi-square test showed no relation between the disorders of the temporomandibular joint and malocclusion or the premature loss of teeth in the group of younger children; in the older group the correlation was significant but of very low degree. The suggestion is made that the correlation between musculo-articular disorders, malocclusions and loss of teeth, is probably determined by the length of time during which the dysfunction is exerting its effect.