Sharon Su

Date of Award

9-26-2025

Department

Department of Orthodontics

First Advisor

Jonas Bianchi

First Committee Member

David Hatcher

Second Committee Member

Heesoo Oh

Abstract

Objectives: To evaluate three-dimensional craniofacial morphological characteristics and longitudinal changes in children and adolescents with active degenerative joint disease (DJD) compared to controls without DJD. Methods: This retrospective longitudinal observational study included 32 adolescents with active DJD (mean age 13.64±1.91 years) and 32 controls (mean age 13.57±2.56 years) treated at a single center. Pre-treatment (T1) and post-treatment (T2) cone-beam computed tomography (CBCT) scans were used to diagnose the temporomandibular joint (TMJ) condition by one oral maxillofacial radiologist. 3D AI-assisted landmark identification and measurements were also performed. Linear and angular measurements were compared between groups using independent t-tests for initial characteristics and longitudinal changes. Paired t-tests assessed within-group changes, and Spearman’s rank correlation was used to evaluate possible associations between treatment variables and disease progression. Results: At the initial time point (T1), the DJD group demonstrated significantly shorter jugaleto- sella distances bilaterally, reduced mandibular dimensions (B point-to-sella) in the superiorinferior plane, decreased gonion-to-sella distances, smaller condylar widths, and reduced posterior facial height (p< 0.05). Longitudinally, the DJD group showed less forward mandibular growth, reduced increases in ramus height, and smaller gains in posterior facial height. Angular measurements revealed unfavorable changes in the DJD group with decreased SNB, increased ANB, and increased hyperdivergence (p< 0.05). No significant correlations were found between disease progression and treatment variables. Conclusions: This study found a novel finding, that adolescents with active DJD present with distinct craniofacial morphology characterized by shorter maxillary heights (jugale-to-sella). Also, this study showed reduced mandibular dimensions and shorter posterior facial heights. Longitudinally, the DJD group showed overall smaller mean changes and developed increasingly hyperdivergent facial patterns compared to controls. These findings suggest that active DJD significantly impacts craniofacial development during adolescence, warranting considerations in monitoring and treatment approaches.

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