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Vassis S, Sabljic S, Noeldeke B, Sefidroodi M, Küseler A, Klit Pedersen T, Stoustrup P. Effects of orthopedic treatment (distraction splint) on dentofacial deformities in patients with juvenile idiopathic arthritis. Eur J Orthod 2024; 46:cjae005. [PMID: 38376495 DOI: 10.1093/ejo/cjae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joint (TMJ), which can alter mandibular growth and development and result in dentofacial deformities. OBJECTIVE To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity. METHODS The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal-Wallis test. RESULTS Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1. CONCLUSIONS The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Sanja Sabljic
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Beatrice Noeldeke
- Department of Economics, Leibniz University Hannover, Am Königsworther Platz 1, 30167 Hannover, Germany
| | | | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
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Otero MF, Tahoces PG, Mera A, Dalstra M, Verna C, Pedersen TK, Herlin T, Mira J. Quantification of temporomandibular joint space in patients with juvenile idiopathic arthritis assessed by cone beam computerized tomography. Orthod Craniofac Res 2024; 27:203-210. [PMID: 37525623 DOI: 10.1111/ocr.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To describe a method to calculate the total intra-articular volume (inter-osseous space) of the temporomandibular joint (TMJ) determined by cone-beam computed tomography (CBCT). This could be used as a marker of tissue proliferation and different degrees of soft tissue hyperplasia in juvenile idiopathic arthritis (JIA) patients. MATERIALS AND METHODS Axial single-slice CBCT images of cross-sections of the TMJs of 11 JIA patients and 11 controls were employed. From the top of the glenoid fossa, in the caudal direction, an average of 26 slices were defined in each joint (N = 44). The interosseous space was manually delimited from each slice by using dedicated software that includes a graphic interface. TMJ volumes were calculated by adding the areas measured in each slice. Two volumes were defined: Ve-i and Vi , where Ve-i is the inter-osseous space, volume defined by the borders of the fossa and Vi is the internal volume defined by the condyle. An intra-articular volume filling index (IF) was defined as Ve-i /Vi , which represents the filling of the space. RESULTS The measured space of the intra-articular volume, corresponding to the intra-articular soft tissue and synovial fluid, was more than twice as large in the JIA group as in the control group. CONCLUSION The presented method, based on CBCT, is feasible for assessing inter-osseus joint volume of the TMJ and delimits a threshold of intra-articular changes related to intra-articular soft tissue proliferation, based on differences in volumes. Intra-articular soft tissue is found to be enlarged in JIA patients.
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Affiliation(s)
- María Florinda Otero
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo G Tahoces
- Departamento de Electrónica e Computación, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Mera
- Rheumatology Service, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Michel Dalstra
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Carlalberta Verna
- Department of Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, Basel, Switzerland
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Troels Herlin
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Jorge Mira
- Departamento de Física Aplicada and Instituto de Materiais (iMATUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Ferlias N, Gjørup H, Doherty MA, Pedersen TK. Pycnodysostosis: Characteristics of teeth, mouth and jaws. Orthod Craniofac Res 2024. [PMID: 38532649 DOI: 10.1111/ocr.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES To describe the clinical and radiographic oro-dental characteristics of patients with pycnodysostosis (PDO). MATERIALS & METHODS A short interview and clinical examination of seven patients with PDO were performed as well as assessment of the temporomandibular joints and masticatory muscles using the diagnostic criteria for temporomandibular disorders, DC-TMD form. A full set of records were taken including photos and intraoral scan. Finally, existing cone beam computed tomography (CBCT) images and radiographs were also studied. RESULTS All patients presented with bimaxillary micrognathia, five had a convex profile, and two had a straight profile. In addition, posterior open bite, Angle Class III molar relation with accompanying anterior crossbite and a grooved median palate were common findings. No patient showed symptoms of temporomandibular disorder (TMD) apart from some clicking. Finally, the main radiographic findings were the obtuse mandibular angle, the frontal bossing, the elongation of the coronoid/condylar process and the presence of hypercementosis with obliterated pulp chambers. CONCLUSION The examined patients with PDO were characterized by dental crowding, malocclusion (anterior crossbite, posterior open bite), hypercementosis, obliterated pulp chambers and deviations in mandibular morphology. In conclusion, patients with PDO have a specific need for dental and orthodontic monitoring with focus on crowding and posterior open bite. The patients will benefit from a long-term orthodontic plan including extractions.
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Affiliation(s)
- Nikolaos Ferlias
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Hans Gjørup
- Department of Oral and Maxillofacial Surgery, Center for Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Mia Aagaard Doherty
- Childhood Cancer Research Group, Danish Cancer Research Institute, Copenhagen, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Rongo R, Michelotti A, Pedersen TK, Resnick CM, Stoustrup P. Management of temporomandibular joint arthritis in children and adolescents: An introduction for orthodontists. Orthod Craniofac Res 2023; 26 Suppl 1:151-163. [PMID: 37226648 DOI: 10.1111/ocr.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 05/26/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease of childhood. JIA can affect any joint and the temporomandibular joint (TMJ) is one of the joints most frequently involved. TMJ arthritis impacts mandibular growth and development and can result in skeletal deformity (convex profile and facial asymmetry), and malocclusion. Furthermore, when TMJs are affected, patients may present with pain at joint and masticatory muscles and dysfunction with crepitus and limited jaw movement. This review aims to describe the role of orthodontists in the management of patients with JIA and TMJ involvement. This article is an overview of evidence for the diagnosis and treatment of patients with JIA and TMJ involvement. Screening for the orofacial manifestation of JIA is important for orthodontists to identify TMJ involvement and related dentofacial deformity. The treatment protocol of JIA with TMJ involvement requires an interdisciplinary collaboration including orthopaedic/orthodontic treatment and surgical interventions for the management of growth disturbances. Orthodontists are also involved in the management of orofacial signs and symptoms; behavioural therapy, physiotherapy and occlusal splints are the suggested treatments. Patients with TMJ arthritis require specific expertise from an interdisciplinary team with members knowledgeable in JIA care. Since disorders of mandibular growth often appear during childhood, the orthodontist could be the first clinician to see the patient and can play a crucial role in the diagnosis and management of JIA patients with TMJ involvement.
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Affiliation(s)
- Roberto Rongo
- Department of Neurosciences, Reproductive sciences and Oral Sciences, School of Orthodontics, University of Naples "Federico II", Naples, Italy
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive sciences and Oral Sciences, School of Orthodontics, University of Naples "Federico II", Naples, Italy
| | - Thomas Klit Pedersen
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Peter Stoustrup
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
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Aiyar A, Pedersen TK, Resnick CM, Nørholt SE, Verna C, Stoustrup PB. Management of unilateral craniofacial microsomia with orthopaedic functional appliances: A systematic literature review. Orthod Craniofac Res 2023. [PMID: 37987216 DOI: 10.1111/ocr.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
The study aimed to summarize current knowledge regarding the use of orthopaedic functional appliances (OFA) in managing unilateral craniofacial microsomia (UCM). The eligibility criteria for the review were (1) assessing use of OFA as a stand-alone treatment and (2) using OFA in combination during or after MDO. The PICO (population, intervention, comparison and outcome) format formulated clinical questions with defined inclusion and exclusion criteria. No limitations concerning language and publication year were applied. Information sources: A literature search of Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, Web of Science databases without restrictions up to 30 September 2022. The risk of bias was assessed. According to Cochrane and PRISMA guidelines, two independent authors conducted data extraction. The level of evidence for included articles was evaluated based on the Oxford evidence-based medicine database. Due to the heterogeneity of studies and insufficient data for statistical pooling, meta-analysis was not feasible. Therefore, the results were synthesized narratively. A total of 437 articles were retrieved. Of these, nine met inclusion criteria: five assessing OFA and four assessing OFA during or after MDO. There is limited evidence to suggest that stand-alone and combination treatment with OFA is beneficial for treating mild-to-moderate UCM-related dentofacial deformities in short term. No studies assessed the burden of care. In the management of UCM, there is insufficient evidence supporting the efficacy of OFA as a stand-alone treatment or when combined with MDO. Additionally, there is a lack of evidence regarding treatment protocols and the effect on the condyles and the TMJ. The study was registered at Prospero database number CRD42020204969.
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Affiliation(s)
- Akila Aiyar
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Cory M Resnick
- Harvard School of Dental Medicine and Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus Univerisity, Aarhus, Denmark
| | - Carlalberta Verna
- Department of Paediatric Oral Heath and Orthodontics, University Centre for Dental Medicine UZB University of Basel, Basel, Switzerland
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Vassis S, Resnick CM, Nørgaard M, Strawn KM, Grove H, Noeldeke B, Herlin T, Pedersen TK, Stoustrup PB. Impact of physiotherapy on orofacial manifestations of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:116. [PMID: 37828517 PMCID: PMC10571390 DOI: 10.1186/s12969-023-00900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Physiotherapy appears as a promising therapy option for patients with Juvenile Idiopathic Arthritis (JIA) [1, 2], but the effects of physiotherapy and jaw exercises on JIA-related orofacial symptoms remain unknown [3]. The aim of this proof-of-concept study was to assess the impact of orofacial physiotherapy and home-exercise programs in patients with JIA and temporomandibular joint (TMJ) involvement. METHODS Twelve patients with JIA and TMJ involvement received a treatment of physiotherapy, complemented by prescribed home exercises spanning over eight weeks. Orofacial symptoms and dysfunction were monitored pre-treatment, during treatment, after treatment, and at a three-months follow-up. RESULTS Orofacial pain frequency and intensity significantly decreased during the course of the treatment (p = 0.009 and p = 0.006), with further reductions observed at the three-month follow-up (p = 0.007 and p = 0.002). During treatment, the mandibular function improved significantly in terms of maximal mouth opening capacity, laterotrusion, and protrusion. CONCLUSIONS This proof-of-concept study shows favourable effects of physiotherapy and home excercises in the management of JIA-related orofacial symptoms and dysfunctions.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark.
| | - Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard Medical School, 188 Longwood Avenue, Boston, MA, 02115, United States of America
| | - Mette Nørgaard
- Department of Physiotherapy, Aarhus University Hospital, Skejby, Denmark, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Kathleen M Strawn
- Department of Physical and Occupational Therapy, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, United States of America
| | - Helle Grove
- Mårslet Fysioterapi & Traeningscenter, Hørretvej 16 C, Mårslet, 8320, Denmark
| | - Beatrice Noeldeke
- Leibniz University Hannover, Welfengarten 1, 30167, Hannover, Germany
| | - Troels Herlin
- Department of Clinical Medicine, Department of Paediatrics, Aarhus University, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
| | - Peter Bangsgaard Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
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Krarup H, Pedersen TK, Frid P, Nørholt SE. Long-Term Follow-Up of Orthognathic Surgery in 19 Patients with Juvenile Idiopathic Arthritis. J Oral Maxillofac Res 2023; 14:e4. [PMID: 38222878 PMCID: PMC10783879 DOI: 10.5037/jomr.2023.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/30/2023] [Indexed: 01/16/2024]
Abstract
Objectives Dentofacial deformity following juvenile idiopathic arthritis with temporomandibular joint involvement is associated with functional, aesthetic, and psychosocial impairment. Surgical treatment may involve combinations of orthognathic surgery. The aims of this retrospective study were to assess orofacial symptoms, functional and aesthetic status, and stability after orthognathic surgery. Material and Methods Nineteen patients with juvenile idiopathic arthritis of the temporomandibular joint (TMJ) and dentofacial deformities were included. All patients were treated with combinations of bilateral sagittal split osteotomy, Le Fort I and/or genioplasty, between September 10, 2007 and October 17, 2017. Analysis of patient symptoms and clinical registrations, and frontal/lateral cephalograms was performed pre- and postoperative and long-term (mean: 3.8 and 2.6 years, respectively). Results Patients experienced no changes in orofacial symptoms or TMJ function, and stable normalisation of horizontal and vertical incisal relations at long-term (horizontal overbite; vertical overbite: P < 0.05). Mandibular lengthening was achieved postoperatively (from mean 79.7 to 87.2 mm; P = 0.004) and was stable. Sella-nasion to A point (SNA) and sella-nasion to B point (SNB) angles increased postoperatively (SNA, mean 79.9° to 82.8°; P = 0.022 and SNB, mean 73.9° to 77.8°; P = 0.003), however, largely reverted to preoperative status at long-term. Conclusions Orthognathic surgery normalized incisal relations while providing stable mandibular lengthening without long-term deterioration of temporomandibular joint function or orofacial symptoms. No long-term effect on jaw advancements was observed.
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Affiliation(s)
- Henrik Krarup
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
| | - Thomas Klit Pedersen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, AarhusDenmark.
| | - Paula Frid
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, TromsøNorway.
- Public Dental Service Competence Centre of North Norway, TromsøNorway.
- Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø
Norway.
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section for Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, AarhusDenmark.
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Niu X, Moland J, Pedersen TK, Bilgrau AE, Cattaneo PM, Glerup M, Stoustrup P. Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:32. [PMID: 35477405 PMCID: PMC9044879 DOI: 10.1186/s12969-022-00691-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This retrospective, cross-sectional study aimed to assess the pharyngeal airway dimensions of patients with juvenile idiopathic arthritis (JIA) and moderate/severe JIA-related dentofacial deformity (mandibular retrognathia/micrognathia), and compare the results with JIA patients with a normal mandibular appearance and a group of non-JIA patients. METHODS Seventy-eight patients were retrospectively included in a 1:1:1 manner as specified below. All patients had previously been treated at the Section of Orthodontics, Aarhus University, Denmark. All had a pretreatment cone beam computed tomography (CBCT). Group 1 (JIA+); 26 JIA patients with severe arthritis-related dentofacial deformity and mandibular retrognathia/micrognathia. Group 2 (JIA-); 26 JIA patients with normal mandibular morphology/position. Group 3 (Controls); 26 non-JIA subjects. Dentofacial morphology and upper airway dimensions, excluding the nasal cavity, were assessed in a validated three-dimensional (3D) fashion. Assessment of dentofacial deformity comprised six morphometric measures. Assessment of airway dimensions comprised nine measures. RESULTS Five morphometric measures of dentofacial deformity were significantly deviating in the JIA+ group compared with the JIA- and control groups: Posterior mandibular height, anterior facial height, mandibular inclination, mandibular occlusal inclination, and mandibular sagittal position. Five of the airway measurements showed significant inter-group differences: JIA+ had a significantly smaller nasopharyngeal airway dimension (ad2-PNS), a smaller velopharyngeal volume, a smaller minimal cross-sectional area and a smaller minimal hydraulic diameter than JIA- and controls. No significant differences in upper airway dimensions were seen between JIA- and controls. CONCLUSION JIA patients with severe arthritis-related dentofacial deformity and mandibular micrognathia had significantly restricted upper airway dimensions compared with JIA patients without dentofacial deformity and controls. The restrictions of upper airway dimension seen in the JIA+ group herein were previously associated with sleep-disordered breathing in the non-JIA background population. Further studies are needed to elucidate the role of dentofacial deformity and restricted airways in the development of sleep-disordered breathing in JIA.
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Affiliation(s)
- Xiaowen Niu
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Julianne Moland
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Anders Ellern Bilgrau
- grid.5117.20000 0001 0742 471XDepartment of Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Paolo M. Cattaneo
- grid.7048.b0000 0001 1956 2722Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia, Formerly, Section of Orthodontics, Aarhus University, Denmark, Aarhus, Denmark
| | - Mia Glerup
- grid.154185.c0000 0004 0512 597XDepartment of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.
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Ferlias N, Gjørup H, Doherty MA, Haagerup A, Pedersen TK. Obstructive Sleep Apnoea in pycnodysostosis; a three-dimensional upper airway analysis. Orthod Craniofac Res 2021; 25:494-501. [PMID: 34963019 DOI: 10.1111/ocr.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/04/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
AIM To assess the upper airway (UA) morphology in patients with pycnodysostosis with a 3D analysis, compare results with normative data and investigate correlation of the total volume (TV) to other UA morphology variables. MATERIALS AND METHODS Cone beam computed tomography (CBCT) images of eight Danish patients with pycnodysostosis (4 males, 4 females with a mean age of 31.8 years, SD:16.3 years), were analysed using Mimics® (Materialise®, Belgium) and compared with a sex- and age-matched control group (6 males, 8 females with a mean age of 33.6 years, SD:18.6 years). RESULTS The distance from the tip of the epiglottis (E) to the Frankfurt horizontal plane (Fp) was significantly shorter in the pycnodysostosis group (p < 0.042). Regarding the cross-sectional measurements, at the "maximum constriction" (p < 0.005), the "upper airway limit" (p < 0.001) and the "lower airway limit" (p < 0.035) cross-sections were significantly smaller in the pycnodysostosis group. The volumes "nasopharynx" (p < 0.002) and "total airway" (TV) (p < 0.01) were also significantly smaller. CONCLUSION Patients with pycnodysostosis have a reduced total airway as well as nasopharyngeal volume compared with matched controls. Additionally, they have a reduced cross-sectional area in the upper and lower borders of the UA, and the area of maximum constriction is also reduced. These factors might explain the high prevalence of obstructive sleep apnoea in pycnodysostosis. TV is positively correlated to total length and cross-sections at all levels including the maximum constriction area as well as the anteroposterior dimension at the upper and lower airway borders.
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Hans Gjørup
- Department of Oral and Maxillofacial Surgery, Center for, Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Annette Haagerup
- NIDO Denmark, Hospital Unit West and Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Pedersen TK, Stoustrup P. How to diagnose idiopathic condylar resorptions in the absence of consensus-based criteria? J Oral Maxillofac Surg 2021; 79:1810-1811. [PMID: 34097867 DOI: 10.1016/j.joms.2021.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/20/2022]
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Ferlias N, Gjørup H, Aagaard Doherty M, Haagerup A, Klit Pedersen T. Three-dimensional analysis of craniofacial morphology in patients with pycnodysostosis. Orthod Craniofac Res 2021; 24:568-574. [PMID: 33608959 DOI: 10.1111/ocr.12479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/19/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To perform a 3D cephalometric analysis of the craniofacial characteristics of patients with pycnodysostosis and compare this with a matched control group. SETTING AND SAMPLE POPULATION This cross-sectional descriptive study assessed eight CBCTs obtained in patients with pycnodysostosis (4 males, 4 females, mean age: 31.8 years). MATERIALS AND METHODS Eight Danish patients with pycnodysostosis were seen at the University's Orthodontic Clinic. All CBCTs were analysed using the Mimics 21.0 software (Materialise®, Belgium) and compared with a control group (6 males, 8 females, mean age: 33.6 years). RESULTS Interclass correlation coefficient showed excellent intra-rater reliability (> 0.93). All measurements in the 3D cephalometric analysis revealed statistical significance (P < .05) when compared with controls. Patients with pycnodysostosis generally had significantly smaller maxilla in the transverse (P < .001), sagittal (P < .002) and vertical (P < .001) dimensions. Their mandibles were also smaller vertically (P < .001) and in length (P < .001). Gonial angle was significantly larger than controls (P < .001), while mandibular volumes were considerably smaller (P < .001). CONCLUSION Patients with pycnodysostosis have significantly smaller jaws in the vertical, sagittal and transverse dimensions compared with controls. Furthermore, the gonial angle was significantly larger, while the volume of the mandible was significantly smaller.
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Hans Gjørup
- Department of Oral and Maxillofacial Surgery, Center for Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Annette Haagerup
- NIDO Denmark, Hospital Unit West and Institute of Clinical Medicine Faculty of Health Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Stoustrup P, Herlin T, Spiegel L, Rahimi H, Koos B, Pedersen TK, Twilt M. Standardizing the Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: An Interdisciplinary, Consensus-based, Short Screening Protocol. J Rheumatol 2019; 47:1397-1404. [PMID: 31787607 DOI: 10.3899/jrheum.190661] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To develop a consensus-based, standardized, short (< 3 min) clinical examination protocol to assess the multidimensional, orofacial manifestations of juvenile idiopathic arthritis (JIA). METHODS The study was conducted by a multidisciplinary task force from the Temporomandibular Joint Juvenile Arthritis Working Group (TMJaw). The study used an acknowledged sequential approach involving (1) a global multidisciplinary online questionnaire study, (2) a systematic literature review and consensus meetings to identify items for inclusion, (3) pilot testing of included items, (4) test of reliability in 22 subjects with JIA by 4 examiners, (5) test of construct validity in a case-control study involving 167 subjects, and (6) establishment of final recommendations. RESULTS Six items were recommended for the final examination protocol: (1) clinician-assessed pain location, (2) temporomandibular (TMJ) joint pain on palpation (open and closed mouth), (3) mandibular deviation at maximal mouth opening (≥ 3 mm), (4) maximal unassisted mouth opening capacity, (5) frontal facial symmetry, and (6) facial profile. All recommended items showed acceptable reliability and construct validity. The average mean examination time was 2 min and 42 s (SD ± 38.5 s). CONCLUSION A consensus-based, short clinical examination protocol was developed. The protocol takes less than 3 min to complete and provides information about orofacial symptoms, TMJ dysfunction, and dentofacial deformity. The standardized examination protocol is applicable to routine clinical care, as well as future research studies.
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Affiliation(s)
- Peter Stoustrup
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany. .,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital.
| | - Troels Herlin
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital
| | - Lynn Spiegel
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital
| | - Hanna Rahimi
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital
| | - Bernd Koos
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital
| | - Thomas Klit Pedersen
- From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.,P. Stoustrup, DDS, PhD, Associate Professor of Orthodontics, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; T. Herlin, Professor, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; H. Rahimi, MD, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; B. Koos, DDS, PhD, Professor, Department of Orthodontics, University Hospital Tübingen; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital
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13
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Stoustrup P, Pedersen TK, Nørholt SE, Resnick CM, Abramowicz S. Interdisciplinary Management of Dentofacial Deformity in Juvenile Idiopathic Arthritis. Oral Maxillofac Surg Clin North Am 2019; 32:117-134. [PMID: 31699581 DOI: 10.1016/j.coms.2019.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Temporomandibular joint (TMJ) arthritis impacts mandibular growth and development. This can result in skeletal deformity, such as facial asymmetry and/or malocclusion asymmetry. This article reviews the unique properties of TMJ and dentofacial growth and development in the setting of juvenile idiopathic arthritis (JIA). Specific orthopedic/orthodontic and surgical management of children with JIA and TMJ arthritis is discussed. The importance of interdisciplinary collaboration is highlighted.
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Affiliation(s)
- Peter Stoustrup
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9-11, 8000 Aarhus C, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9-11, 8000 Aarhus C, Denmark; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark; Section of Oral Maxillofacial Surgery, Aarhus University, Vennelyst Boulevard 9-11, 8000 Aarhus, Denmark
| | - Cory M Resnick
- Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 longwood Avenue, Boston, MA 02115, USA; Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
| | - Shelly Abramowicz
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Emory University, 1365 Clifton Road, Building B, Suite 2300, Atlanta, GA 30322, USA.
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14
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Glerup M, Stoustrup P, Matzen LH, Rypdal V, Nordal E, Frid P, Arnstad ED, Rygg M, Thorarensen O, Ekelund M, Berntson L, Fasth A, Nilsson H, Peltoniemi S, Aalto K, Arte S, Toftedal P, Nielsen S, Kreiborg S, Herlin T, Pedersen TK. Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis: 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort. J Rheumatol 2019; 47:730-738. [PMID: 31523047 DOI: 10.3899/jrheum.190231] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset. METHODS Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used. RESULTS Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective. CONCLUSION This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.
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Affiliation(s)
- Mia Glerup
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark. .,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital.
| | - Peter Stoustrup
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Louise H Matzen
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Veronika Rypdal
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Ellen Nordal
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Paula Frid
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Ellen Dalen Arnstad
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Marite Rygg
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Olafur Thorarensen
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Maria Ekelund
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Lillemor Berntson
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Anders Fasth
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Håkan Nilsson
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Suvi Peltoniemi
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Kristiina Aalto
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Sirpa Arte
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Peter Toftedal
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Susan Nielsen
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Sven Kreiborg
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Troels Herlin
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
| | - Thomas Klit Pedersen
- From the Department of Pediatrics, Aarhus University Hospital; Section of Orthodontics, Aarhus University; Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Pediatrics, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø; Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway, Tromsø; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger; Department of Pediatrics, St. Olavs Hospital, Trondheim; Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital, Trondheim, Norway; Department of Pediatrics, Ryhov County Hospital, Jönköping; Department of Women's and Children's Health, Uppsala University, Uppsala; Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki; Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Pediatrics, Copenhagen University Hospital, Copenhagen; Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen, Copenhagen; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Stoustrup, Associate Professor, DDS, PhD, Section of Orthodontics, Aarhus University; L.H. Matzen, DDS, PhD, Associate Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University; V. Rypdal, MD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; E. Nordal, MD, PhD, Department of Pediatrics, University Hospital of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; P. Frid, DDS, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, and Department of Otorhinolaryngology and Department and Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Center of North Norway; E.D. Arnstad, MD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust; M. Rygg, MD, Professor, PhD, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, and Department of Pediatrics, St. Olavs Hospital; O. Thorarensen, DDS, Department of Oral and Craniomaxillofacial Surgery, St. Olavs Hospital; M. Ekelund, MD, Department of Pediatrics, Ryhov County Hospital, and Department of Women's and Children's Health, Uppsala University; L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University; A. Fasth, MD, PhD, Professor, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg; H. Nilsson, DDS, PhD, Dr. Odont, Department of Oral and Maxillofacial Surgery/Stomatognathic Physiology, The Institute for Postgraduate Dental Education; S. Peltoniemi, MD, Hospital for Children and Adolescents, University of Helsinki; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; S. Arte, DDS, PhD, Orthodontics, Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital; P. Toftedal, MD, PhD, Department of Pediatrics, Copenhagen University Hospital; S. Nielsen, MD, Department of Pediatrics, Copenhagen University Hospital; S. Kreiborg, Professor, DDS, PhD, Dr. Odont, Department of Pediatric Dentistry and Clinical Genetics, University of Copenhagen; T. Herlin, Professor, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; T.K. Pedersen, Professor, DDS, PhD, Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital
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15
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Botticelli S, Küseler A, Mølsted K, Andersen HS, Boers M, Shoeps A, Emborg BK, Kisling-Møller M, Pedersen TK, Andersen M, Willadsen E. Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:420-429. [DOI: 10.1177/1055665619874143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair. Design: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft). Setting: Tertiary health care. One surgical center. Patients and Methods: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months). Main outcome measurements: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency. Results: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate “cleft size at tuberosity level” was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = −.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99). Conclusions: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Aarhus University, Denmark
- Cleft Lip and Palate Center, IKH, Region Midt, Aarhus, Denmark
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Denmark
- Cleft Lip and Palate Center, IKH, Region Midt, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | | | - Maria Boers
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | - Antje Shoeps
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | | | | | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark
| | - Mikael Andersen
- Department of Plastic Surgery and Burns Treatment, University Hospital of Copenhagen, Denmark
| | - Elisabeth Willadsen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Denmark
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16
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Botticelli S, Küseler A, Mølsted K, Ovsenik M, Nørholt SE, Dalstra M, Cattaneo PM, Pedersen TK. Palatal morphology in unilateral cleft lip and palate patients: Association with infant cleft dimensions and timing of hard palate repair. Orthod Craniofac Res 2019; 22:270-280. [PMID: 31056824 DOI: 10.1111/ocr.12318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/05/2019] [Accepted: 04/26/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the impact of cleft severity and timing of hard palate repair on palatal dimensions in unilateral cleft lip and palate (UCLP) children. SETTING AND SAMPLE POPULATION Single-centre analysis within a multicenter RCT of primary surgery; 122 UCLP randomized to early hard palate closure (EHPC) at 12 months or delayed hard palate closure (DHPC) at 36 months; 28 frequency-matched controls. METHODS Linear measurements of palatal height, width and length were performed on 116 digital models of UCLP subjects (8.21 years, SD = 0.53) and 28 models of non-cleft individuals (8.44 years SD = 0.72). Cleft dimensions at infancy (mean 1.8 months) were considered. In a pilot study, shell-to-shell distances between the 3D cleft palate objects and a reference mesh were calculated and differences between the groups assessed. Morphological differences were visualized using colour mapping. RESULTS Compared to controls, UCLP subjects presented a higher palate at the level of the anterior scar (P = 0.002), but generally a lower palate in the middle region (P < 0.001). Comparing UCLP subgroups, the DHPC subjects showed a flatter palate posteriorly (P = 0.048) and the EHPC group exhibited more transversal constriction (P = 0.003 at M1 level). 3D analysis revealed a shallower palate in the DHPC group both in the middle (P = 0.002) and the posterior part (P = 0.008). Anterior cleft severity correlated negatively with palatal height (P = 0.01). CONCLUSIONS Unilateral cleft lip and palate palates differ from controls in width and height. DHPC may represent an advantage for the transversal dimension, but a disadvantage for palatal height. Infant cleft dimensions partially explain differences in palatal height.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center-University Hospital of Copenhagen, Copenhagen, Denmark
| | - Maja Ovsenik
- Department of Orthodontics and Dentofacial Orthopedics, University of Ljubljana, Ljubljana, Slovenia
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark
| | - Michel Dalstra
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | | | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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17
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Stoustrup P, Resnick CM, Pedersen TK, Abramowicz S, Michelotti A, Küseler A, Verna C, Kellenberger CJ, Nordal EB, Caserta G, Jankovska I, Halbig JM, Kristensen KD, Arvidsson LZ, Spiegel L, Stoll ML, Lerman M, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomäki T, Herlin T, Peacock ZS, Twilt M. Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis: International, Multidisciplinary Consensus-based Recommendations. J Rheumatol 2019; 46:518-522. [PMID: 30647179 DOI: 10.3899/jrheum.180785] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To propose multidisciplinary, consensus-based, standardization of operational terminology and method of assessment for temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA). METHODS Using a sequential expert group-defined terminology and methods-of-assessment approach by (1) establishment of task force, (2) item generation, (3) working group consensus, (4) external expert content validity testing, and (5) multidisciplinary group of experts final Delphi survey consensus. RESULTS Seven standardized operational terms were defined: TMJ arthritis, TMJ involvement, TMJ arthritis management, dentofacial deformity, TMJ deformity, TMJ symptoms, and TMJ dysfunction. CONCLUSION: Definition of 7 operational standardized terms provides an optimal platform for communication across healthcare providers involved in JIA-TMJ arthritis management.
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Affiliation(s)
- Peter Stoustrup
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland. .,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital.
| | - Cory M Resnick
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Thomas Klit Pedersen
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Shelly Abramowicz
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Ambra Michelotti
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Annelise Küseler
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Carlalberta Verna
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Christian J Kellenberger
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Ellen Berit Nordal
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Giuliana Caserta
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Iveta Jankovska
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Josefine Mareile Halbig
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Kasper Dahl Kristensen
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Linda Z Arvidsson
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Lynn Spiegel
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Mathew L Stoll
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Melissa Lerman
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Mia Glerup
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Patrizia Defabianis
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Paula Frid
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Per Alstergren
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Randy Q Cron
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Sarah Ringold
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Sven Erik Nørholt
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Timo Peltomäki
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Troels Herlin
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Zachary S Peacock
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Marinka Twilt
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
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Rahimi H, Twilt M, Herlin T, Spiegel L, Pedersen TK, Küseler A, Stoustrup P. Orofacial symptoms and oral health-related quality of life in juvenile idiopathic arthritis: a two-year prospective observational study. Pediatr Rheumatol Online J 2018; 16:47. [PMID: 30005677 PMCID: PMC6043998 DOI: 10.1186/s12969-018-0259-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/13/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Little is known about the chronicity of orofacial symptoms and how this influences the oral health-related quality of life in juvenile idiopathic arthritis (JIA). Therefore, our objectives were to study the long-term changes in self-reported orofacial symptoms, and to define the impact of orofacial symptoms on oral health-related quality of life in JIA. METHODS At baseline (T0), 157 consecutive JIA patients ≤20 years completed a patient pain questionnaire that incorporates domains related to the orofacial area. At the 2 year follow-up (T1), 113 patients completed the same questionnaire (response rate 72%) in addition to the Child Perception's Questionnaire; a validated 31-item questionnaire addressing oral health-related quality of life. RESULTS At T0, 53% (60/113) of patients reported the presence of orofacial pain, and 36% (41/113) of patients reported compromised orofacial function. At T1, 77% (46/60) of patients with pain at T0 reported persistent pain, and 66% (27/41) of patients with functional disability at T0 reported persistent disability. Patients with orofacial symptoms reported a significantly greater prevalence of negative impact of orofacial conditions on general quality of life and within the domains of emotional and social well-being compared to asymptomatic patients. CONCLUSION Self-reported orofacial pain and functional disability were common findings in a cohort of JIA patients followed over 2 years. These symptoms seem to persist over time in most patients, and have a significant negative impact on oral health-related quality of life.
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Affiliation(s)
- Hanna Rahimi
- 0000 0004 0512 597Xgrid.154185.cDepartment of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 121, 8200 Aarhus N, Denmark
| | - Marinka Twilt
- grid.454131.6Department of Pediatrics, Division of Rheumatology, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB Canada
| | - Troels Herlin
- 0000 0004 0512 597Xgrid.154185.cDepartment of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 121, 8200 Aarhus N, Denmark
| | - Lynn Spiegel
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
| | - Thomas Klit Pedersen
- 0000 0004 0512 597Xgrid.154185.cDepartment of Oral and Maxillofacial Surgery, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark ,0000 0001 1956 2722grid.7048.bSection of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9-11, 8000 Aarhus C, Denmark
| | - Annelise Küseler
- 0000 0004 0512 597Xgrid.154185.cDepartment of Oral and Maxillofacial Surgery, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark ,0000 0001 1956 2722grid.7048.bSection of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9-11, 8000 Aarhus C, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9-11, 8000, Aarhus C, Denmark.
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Economou S, Stoustrup P, Kristensen KD, Dalstra M, Küseler A, Herlin T, Pedersen TK. Evaluation of facial asymmetry in patients with juvenile idiopathic arthritis: Correlation between hard tissue and soft tissue landmarks. Am J Orthod Dentofacial Orthop 2018; 153:662-672.e1. [DOI: 10.1016/j.ajodo.2017.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/27/2022]
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Botticelli S, Pedersen TK, Küseler A, Nørholt SE, Cattaneo PM. Novel 3-D Analysis for the Assessment of Cleft Dimensions on Digital Models of Infants With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2018; 56:127-133. [DOI: 10.1177/1055665618770795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To present a 3-D standardized analysis of cleft dimensions. Materials: Thirty-one plaster casts of unilateral cleft lip and palate (UCLP) infants were laser scanned. Landmarks and coordinate system were defined. Linear distances and surfaces were measured, and the ratio between cleft and palatal area was calculated (3-D infant cleft severity ratio [3D ICSR]). The digitally measured areas were compared with silicone membranes, adapted to the plaster casts, and analyzed by optic microscopy. Main Outcome Measures: Repeatability, reproducibility, and validity. Results: Bland-Altman plots showed minor bias for anterior cleft width (0.16 mm), arch length (0.23 mm), and palatal surface (−9.18 mm2). The random error was maximum 0.78 mm for linear measurements and 12.1 mm2 for area measurements, reliability of 3D ICSR was 0.99 (intraclass correlation coefficient), differences between measurements on digital and plaster models were less than 2%. Conclusions: The method offers valid and reproducible 3-D assessment of cleft size and morphology. 3-D infant cleft severity ratio can be used as baseline value for surgical planning and may have a role in predicting dentofacial development.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Cleft Lip and Palate Department, Institut for Kommunikationog Handicap, Region Midt-Aarhus, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Annelise Küseler
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Cleft Lip and Palate Department, Institut for Kommunikationog Handicap, Region Midt-Aarhus, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
- Section of Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Paolo M. Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Stoustrup P, Iversen CK, Kristensen KD, Resnick CM, Verna C, Nørholt SE, Abramowicz S, Küseler A, Cattaneo PM, Herlin T, Pedersen TK. Assessment of dentofacial growth deviation in juvenile idiopathic arthritis: Reliability and validity of three-dimensional morphometric measures. PLoS One 2018. [PMID: 29534095 PMCID: PMC5849319 DOI: 10.1371/journal.pone.0194177] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction Patients with juvenile idiopathic arthritis (JIA) and involvement of the temporomandibular joint (TMJ) often experience abnormal facial growth. Three-dimensional (3D) assessment of dentofacial growth deviation has become more common with advancement and commercialization of imaging technologies. However, no standardized guidelines exist for interpretation of 3D imaging in patients with JIA. The aim of this study was to propose and validate morphometric measures for the 3D radiographic assessment of dentofacial growth deviation in patients with JIA to enhance: 1) Description of dentofacial growth deviation; 2) Treatment planning; 3) Longitudinal follow-up. Methods The study was conducted in a standardized sequential-phased approach involving: 1) Preliminary decision-making; 2) Item generation; 3) Test of content-validity; 4) Test of reliability; 5) Test of construct validity; 6) Establishment of final recommendations. Results Twenty-one morphometric measures were evaluated. Based on results of reliability and validity-testing including subjects with JIA (n = 70) and non-JIA controls (n = 19), seven measures received a “high recommendation” score. Those measures were associated with posterior mandibular height, occlusal cant, mandibular asymmetry, mandibular inclination, and anterior/posterior lower face height. Nine other measures were “moderately recommended” and five received a “somewhat recommendation” score. Conclusion Seven morphometric measures were considered very useful in the 3D assessment of growth deviation in patients with TMJ disease associated with JIA. These variables can be used to standardize the description of dentofacial deformities and to plan corrective interventions.
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Affiliation(s)
- Peter Stoustrup
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- * E-mail:
| | | | - Kasper Dahl Kristensen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Section of Orthodontics, University of Bergen, Bergen, Norway
| | - Cory M. Resnick
- Harvard School of Dental Medicine, Boston, MA, United States of America
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, United States of America
| | - Carlalberta Verna
- Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
- Section of Oral Maxillofacial Surgery, Aarhus University, Aarhus, Denmark
| | - Shelly Abramowicz
- Oral and Maxillofacial Surgery and Pediatrics, Emory University, Children’s Healthcare of Atlanta, Atlanta, GA, United States of America
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Troels Herlin
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Hügle B, Spiegel L, Hotte J, Wiens S, Herlin T, Cron RQ, Stoll ML, Vinod S, Stoustrup P, Pedersen TK, Twilt M. Isolated Arthritis of the Temporomandibular Joint as the Initial Manifestation of Juvenile Idiopathic Arthritis. J Rheumatol 2017; 44:1632-1635. [PMID: 28864647 DOI: 10.3899/jrheum.170263] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To describe characteristics of patients with juvenile idiopathic arthritis (JIA) presenting with isolated arthritis of the temporomandibular joints (TMJ). METHODS Patients with JIA with isolated TMJ arthritis from 4 large tertiary pediatric rheumatology centers were included. Demographic and clinical data were analyzed using descriptive statistics. RESULTS Fifty-five patients were identified (65% bilateral presentation). Six patients developed arthritis in other joints (median time 6 mos); 4 patients developed uveitis, all prior to arthritis. At last followup, 9% were still taking antirheumatic medications. CONCLUSION JIA TMJ arthritis can occur in isolation, and is probably underdiagnosed. Care providers including dentists and orthodontists should be aware of this presentation.
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Affiliation(s)
- Boris Hügle
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada. .,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary.
| | - Lynn Spiegel
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Julia Hotte
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Stefan Wiens
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Troels Herlin
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Randy Q Cron
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Matthew L Stoll
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Surabhi Vinod
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Peter Stoustrup
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Thomas Klit Pedersen
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
| | - Marinka Twilt
- From the German Center for Pediatric and Adolescent Rheumatology; Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie, Garmisch-Partenkirchen, Germany; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Section of Orthodontics, Aarhus University, Aarhus, Denmark; Children's of Alabama, Division of Pediatric Rheumatology, Birmingham, Alabama, USA; Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,B. Hügle, MD, MSc, German Center for Pediatric and Adolescent Rheumatology; L. Spiegel, MD, Division of Rheumatology, The Hospital for Sick Children; J. Hotte, MD, German Center for Pediatric and Adolescent Rheumatology; S. Wiens, MSc, DDS, Praxisklinik für Mund-Kiefer-Gesichts-Chirurgie and Implantologie; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University Hospital; R.Q. Cron, MD, PhD, Children's of Alabama, Division of Pediatric Rheumatology; M.L. Stoll, MD, PhD, MSCS, Children's of Alabama, Division of Pediatric Rheumatology; S. Vinod, BS, Children's of Alabama, Division of Pediatric Rheumatology; P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; T.K. Pedersen, DDS, PhD, Section of Orthodontics, Aarhus University, Department of Oral and Maxillofacial Surgery, and Aarhus University Hospital; M. Twilt, MD, MSc, PhD, Department of Pediatrics, Aarhus University Hospital, and Department of Pediatrics, Alberta Children's Hospital, University of Calgary
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Kristensen KD, Schmidt B, Stoustrup P, Pedersen TK. Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms. Am J Orthod Dentofacial Orthop 2017; 152:214-223. [PMID: 28760283 DOI: 10.1016/j.ajodo.2016.12.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Our aim was to describe 3-dimensional condylar deformation of the temporomandibular joint (TMJ) and symptoms and signs of temporomandibular dysfunction (TMD) in patients with idiopathic condylar resorption (ICR). METHODS We included 25 patients with ICR and 25 controls. We performed cone-beam computed tomographic scans and analyzed condylar width, length, and height as well as the condylar axial angle and the condylar neck angle. TMJ cross sections were evaluated for degenerative characteristics and location of bony deformations. Furthermore, symptoms and signs of TMD were described in the ICR group. RESULTS In the ICR group, we found statistically significantly reduced condylar width (mean difference, 2.0 mm), height (mean difference, 4.9 mm), and condylar axial angle (mean difference, 10.6°); 84% of the TMJs had a posterior condylar neck angle (control group, 22%). The most common degenerative changes were noncongruent shape of the condyle-fossa relationship (72%), condylar resorption (56%), and nonintact cortex (40%). More than 70% of the joints with bony deformations showed changes along the entire condylar head. Most patients with ICR showed symptoms and signs of TMD; nevertheless, 12% had no signs or symptoms of TMD. CONCLUSIONS ICR in the TMJ changes the shape and reduces the size of the condyle. Deformity locations are unspecified, and the entire condyle is often affected. Most patients with ICR have signs or symptoms of TMD; however, a small group was asymptomatic and without clinical signs.
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Affiliation(s)
- Kasper Dahl Kristensen
- Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; Oral Health Center for Western Norway, Stavanger, Rogaland, Norway.
| | | | - Peter Stoustrup
- Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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24
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Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, Küseler A, Cron RQ, Abramowicz S, Verna C, Peltomäki T, Alstergren P, Petty R, Ringold S, Nørholt SE, Saurenmann RK, Herlin T. Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies. J Rheumatol 2017; 44:326-333. [PMID: 28089967 DOI: 10.3899/jrheum.160796] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. METHODS Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations. RESULTS Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies. CONCLUSION Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.
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Affiliation(s)
- Peter Stoustrup
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland. .,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University.
| | - Marinka Twilt
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Lynn Spiegel
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Kasper Dahl Kristensen
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Bernd Koos
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Thomas Klit Pedersen
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Annelise Küseler
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Randy Q Cron
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Shelly Abramowicz
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Carlalberta Verna
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Timo Peltomäki
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Per Alstergren
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Ross Petty
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Sarah Ringold
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Sven Erik Nørholt
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Rotraud K Saurenmann
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
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Pedersen LK, Maimburg RD, Hertz JM, Gjørup H, Pedersen TK, Møller-Madsen B, Østergaard JR. Moebius sequence -a multidisciplinary clinical approach. Orphanet J Rare Dis 2017; 12:4. [PMID: 28061881 PMCID: PMC5217236 DOI: 10.1186/s13023-016-0559-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/22/2016] [Indexed: 01/31/2023] Open
Abstract
Background Moebius Sequence (MS) is a rare disorder defined by bilateral congenital paralysis of the abducens and facial nerves in combination with various odontological, craniofacial, ophthalmological and orthopaedic conditions. The aetiology is still unknown; but both genetic (de novo mutations) and vascular events in utero are reported. The purpose of present study was through a multidisciplinary clinical approach to examine children diagnosed with Moebius-like symptoms. Ten children underwent odontological, ophthalmological, obstetric, paediatric, orthopaedic, genetic, radiological and photographical evaluation. Five patients maintained the diagnosis of MS according to the diagnostic criteria. Results All five patients had bilateral facial and abducens paralysis confirmed by ophthalmological examination. Three of five had normal brain MR imaging. Two had missing facial nerves and one had missing abducens nerves. The Strengths and Difficulties Questionnaire (SDQ) showed normal scores in three of five patients. Interestingly, two of five children were born to mothers with uterine abnormalities (unicornuate/bicornuate uterus). In the odontological examination three of five showed enamel hypomineralisation. All five had abnormal orofacial motor function and maxillary prognathism. Two patients had adactyly, syndactyly and brachydactyly. None of the five patients had Poland anomaly, hip dislocation or dysplasia but all had a mild degree of scoliosis. We observed congenital club-feet, calcaneovalgus deformities, macrodactyly of one or more toes or curly toes. Pedobarography showed plantar pressures within normal ranges. Conclusions Adherence to standard diagnostic criteria is central in the diagnosis of MS. An accurate diagnosis is the basis for correct discussion of other relevant concomitant symptoms of MS, genetic testing and evaluation of prognosis. The multidisciplinary approach and adherence to diagnostic criteria taken in present study increases the knowledge on the relationship between genotype, phenotype and symptomatology of MS.
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Affiliation(s)
- Line Kjeldgaard Pedersen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. .,Department of Childrens Orthopaedics, Aarhus University Hospital, Aarhus, Denmark.
| | - Rikke Damkjær Maimburg
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Gynaecology-Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Michael Hertz
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Hans Gjørup
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,Department of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Bjarne Møller-Madsen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Childrens Orthopaedics, Aarhus University Hospital, Aarhus, Denmark
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Otero González MF, Pedersen TK, Dalstra M, Herlin T, Verna C. 3D evaluation of mandibular skeletal changes in juvenile arthritis patients treated with a distraction splint: A retrospective follow-up. Angle Orthod 2016; 86:846-853. [PMID: 27003225 PMCID: PMC8600825 DOI: 10.2319/081715-549.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 12/01/2015] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To evaluate three-dimensional (3D) condylar and mandibular growth in patients with juvenile idiopathic arthritis (JIA) with unilateral temporomandibular joint involvement treated with a distraction splint. MATERIALS AND METHODS Cone-beam computed tomography (CBCT) scans were taken for 16 patients with JIA with unilateral TMJ involvement before treatment (T0) and 2 years after treatment (T1). All patients received orthopedic treatment with a distraction splint. Eleven patients without JIA who were undergoing orthodontic treatment without a functional appliance or Class II mechanics and who had taken CBCT scans before and after treatment, served as controls. Reconstructed 3D models of the mandibles at T0 and T1 were superimposed on stable structures. Intra- and intergroup growth differences in condylar and mandibular ramus modifications and growth vector direction of the mandibular ramus were evaluated. RESULTS In all patients with JIA there were asymmetric condylar volume, distal and vertical condylar displacement, and ramus length differences that were smaller on the affected side. Condylar displacement was more distal and less vertical in the JIA group than in the control group. A larger distal growth of the condylar head and a more medial rotation of the ramus on the affected side were found in the JIA group. CONCLUSION The orthopedic functional treatment for patients with JIA allows for condylar adaptation and modeling, thereby hindering, although with a widely variable response, a further worsening of the asymmetry. Unilateral affection has a possible influence on the growth of the nonaffected side.
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Affiliation(s)
- Maria Florinda Otero González
- PhD student, Centro Singular de Investigación en Tecnoloxías da Información (CITIUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Thomas Klit Pedersen
- Professor, Section of Orthodontics, Institute of Odontology, Aarhus University and Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Michel Dalstra
- Associate Professor, Section of Orthodontics, Institute of Odontology, Aarhus University, Aarhus, Denmark
| | - Troels Herlin
- Professor, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Carlalberta Verna
- Professor and Head, Department of Orthodontics and Pediatric Dentistry, University of Basel, Basel, Switzerland, and Visiting Professor, Section of Orthodontics, Institute of Odontology, Aarhus University, Aarhus, Denmark
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Stoustrup P, Kristensen KD, Küseler A, Herlin T, Pedersen TK. Normative values for mandibular mobility in Scandinavian individuals 4-17 years of age. J Oral Rehabil 2016; 43:591-7. [PMID: 27145166 DOI: 10.1111/joor.12407] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/28/2022]
Abstract
Assessment of mandibular mobility is an important part of the clinical oro-facial examination of paediatric and adolescent patients. The aims of the present cross-sectional study were to establish age-related normative values for mandibular mobility in a Scandinavian paediatric and adolescent cohort and to assess the validity of universal cut-off values for lower 'normal' mandibular ranges of motion. A total of 1114 Danish individuals between 4-17 years of age were included. Maximal mouth opening capacity and laterotrusion capacity were assessed, in each individual, according to a standardised measurement protocol. The mean maximal mouth opening capacity gradually increased from 38 mm (SD 6·1 mm) at age 4 to 54·5 mm (SD 6·8 mm) at age 17. No inter-gender difference in maximal mouth opening capacity was observed (P > 0·15). The mean maximal laterotrusion capacity gradually increased from 7·4 mm (SD. 1·1 mm) at age four to 10·1 mm (SD 1·9 mm) at age 17. A statistical significant inter-gender difference of 0·8 mm (SD 0·4 mm) was observed in relation to the total laterotrusion capacity; however, the clinical relevance of this significant difference is questionable. Normative values of mandibular function was established in individuals 4-17 years of age. Our findings oppose the use of a single universal cut-off value for 'normal' range of motion in paediatric and adolescent patients. Instead, we recommend to use the age-related normative values of mandibular range of motion as basis for the assessment of the development of oro-facial function.
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Affiliation(s)
- P Stoustrup
- Section of Orthodontics, Aarhus University, Aarhus C, Denmark
| | - K D Kristensen
- Section of Orthodontics, Aarhus University, Aarhus C, Denmark.,Specialist Oral Health Center for Western Norway, Stavanger, Rogaland, Norway
| | - A Küseler
- Section of Orthodontics, Aarhus University, Aarhus C, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - T Herlin
- Department of Pediatrics, Aarhus University Hospital, Aarhus N, Denmark
| | - T K Pedersen
- Section of Orthodontics, Aarhus University, Aarhus C, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Stoustrup P, Kristensen KD, Küseler A, Pedersen TK, Herlin T. Temporomandibular joint steroid injections in patients with juvenile idiopathic arthritis: an observational pilot study on the long-term effect on signs and symptoms. Pediatr Rheumatol Online J 2015; 13:62. [PMID: 26689191 PMCID: PMC4687278 DOI: 10.1186/s12969-015-0060-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 12/09/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) can lead to orofacial pain and malfunction of the TMJ. Intra-articular corticosteroid injections (IACI) have been suggested as a treatment modality against TMJ arthritis-related orofacial signs and symptoms. However, knowledge of the effect-durability of these injections remains unanswered. The aim of this pilot study was to evaluate the short and long-term effects of IACI on orofacial symptoms in a prospective observational study based on pre-specified clinical examination standards. METHODS Thirteen patients with JIA and arthritis-related orofacial signs and symptoms were included in this prospective pilot study (median 17.2 years, IQR 15-18.4 years). All patients received TMJ IACI (11 bilateral and two unilateral) due to an insufficient response to previous pain-management treatments. Three standardized clinical examinations were carried out: T1 prior to treatment, T2 short-term follow-up (mean 34 days post-treatment), T3 long-term follow-up (mean 333 days post-treatment). RESULTS Significant pain reduction was observed at the short-term follow-up (T2). Resolution of orofacial pain after IACI was a rare finding at T2. Generally, the pain significantly worsened between T2 and T3 examinations. The reported pain levels rose between T2 and T3 indicating a loss of effect of the IACI at the long-term follow-up examination (T3). Non-significant improvements in TMJ mobility were observed at T2 and T3. CONCLUSION Our results suggest a palliative (not curative) effect of IACI for TMJ arthritis-related orofacial symptoms in patients with long-term orofacial pain complaints. The short-term improvements in signs and symptoms were partly resolved at the long-term follow-up.
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Affiliation(s)
- Peter Stoustrup
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.
| | - Kasper Dahl Kristensen
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark. .,Specialist Oral Health Center for Western Norway, Stavanger, Rogaland, Norway.
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark. .,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark. .,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Troels Herlin
- Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus N, Denmark.
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Affiliation(s)
- Troels Herlin
- Department of Pediatrics, Aarhus University Hospital;
| | - Thomas Klit Pedersen
- Department of Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Aarhus, Denmark
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Kristensen KD, Stoustrup P, Alstergren P, Küseler A, Herlin T, Pedersen TK. Signs and symptoms after temporomandibular joint washing and cannula placement assessed by cone beam computerized tomography. Acta Odontol Scand 2015; 73:454-60. [PMID: 25428626 DOI: 10.3109/00016357.2014.983542] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Analyses of temporomandibular joint synovial fluid using the hydroxocobalamin push-pull technique are increasingly used. However, objective complications and subjective experiences from this procedure have not been described. Firstly, this study aimed to describe discomfort and potential side-effects of this method with special emphasis on symptoms related to the arthrocentesis to be used for future patient information and Ethical Committee applications. Secondly, this study aimed to evaluate the use of cone beam computed tomography (CBCT) as control of intra-capsular cannula placement. METHODS Twenty healthy, young adult volunteers were included. Extensive objective and subjective questionnaires were completed before and 14 days after the synovial fluid sampling. With the cannula inside the joints a CBCT was done to investigate if this procedure can be used to verify intra-capsular cannula position. RESULTS The subjective findings: Most subjects did experience mild pain or discomfort post-operatively. In 12 of 20 subjects symptoms had resolved after 2 days and no subjects had symptoms for more than a week. The longer lasting symptoms were mainly transient joint sounds on mandibular movement. Objective findings: 14 days after the sampling mandibular protrusion had improved 1 mm, but all other objective measures were equal compared to baseline. CBCT showed a large variation in cannula position and no conclusions could be drawn from this. CONCLUSION The hydroxocobalamin push-pull synovial fluid sampling may cause minor, transient symptoms. CBCT does not seem to provide any clinical benefits concerning the correct cannula position in relation to the upper joint compartment and disc.
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Andersen K, Svenstrup M, Pedersen TK, Küseler A, Jensen J, Nørholt SE. Stability after Cleft Maxillary Distraction Osteogenesis or Conventional Orthognathic Surgery. J Oral Maxillofac Res 2015; 6:e2. [PMID: 26229581 PMCID: PMC4516854 DOI: 10.5037/jomr.2015.6202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 01/30/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. MATERIAL AND METHODS INCLUSION CRITERIA 1) cleft lip and palate, 2) advancement > 8 mm. Eleven patients comprised the distraction osteogenesis group (DOG). Seven patients comprised the orthognathic treatment group (CONVG). Skeletal and soft tissue points were traced on lateral cephalograms: T1 (preoperatively), T2 (after surgery), T3 (follow-up). Group differences were analyzed using Students t-test. RESULTS At T1-T2, advancement of 6.98 mm (P = 0.002) was observed in DOG. Horizontal overjet increased 11.62 mm (P = 0.001). A point-nasion-B point (ANB) angle increased 8.82° (P = 0.001). Aesthetic plane to upper lip was reduced 5.44 mm (P = 0.017) and the naso-labial angle increased 16.6° (P = 0.001). Vertical overbite (VOB) increased 2.27 mm (P = 0.021). In T2-T3, no significant changes were observed in DOG. In T1-T2, horizontal overjet increased 8.45 mm (P = 0.02). The ANB angle, 9.33° (P = 0.009) in CONVG. At T2-T3, VOB increased, 2.35 mm (P = 0.046), and the ANB angle reduced, 3.83° (P = 0.003). In T2-T3, no parameters changed in CONVG. At follow-up (T3), VOB increased in CONVG compared with DOG, (P = 0.01). Vertical position of A point differed between the groups (P = 0.04). No significant intergroup differences between soft tissue parameters occurred. CONCLUSIONS Distraction osteogenesis resulted in a stable position of the maxilla and movement upwards in vertical plane, however in case of orthognathic treatment sagittal relapse and a continued postoperatively downward movement was registered.
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Affiliation(s)
- Kristian Andersen
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus Denmark
| | | | | | - Annelise Küseler
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus Denmark
| | - John Jensen
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus Denmark
| | - Sven Erik Nørholt
- Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus Denmark
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Andersen K, Pedersen TK, Svendsen P, Hauge EM, Schou S, Nørholt SE. Effect of unilateral mandibular distraction osteogenesis on mandibular morphology in rabbits with antigen-induced temporomandibular joint arthritis. Int J Oral Maxillofac Surg 2015; 44:1052-9. [PMID: 25835759 DOI: 10.1016/j.ijom.2015.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/03/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
Aim was to evaluate effect of unilateral distraction osteogenesis (DO) on mandibular morphology in rabbits with antigen-induced arthritis in the temporomandibular joint (TMJ). Forty 8-week-old rabbits were divided into four groups. In groups A,C, arthritis was induced in the right TMJ. Groups A,B underwent DO. Group D served as control group. Cephalometric analysis of mandibular angle, mandibular ramus height, mandibular collum height, and total posterior mandibular height was done on CT-scans preoperatively (T0), after distraction (T1), and at euthanasia (T2). Two-factor ANOVA evaluated the effect of DO and antigen-induced arthritis. No effect of DO or arthritis was observed on mandibular angle or mandibular collum height. For T0-T1, DO increased mandibular ramus height 12.3% (95% CI 5.2-19.4%) in group B (P=0.001) and total posterior mandibular height 6.2% (95% CI 0.3-12.1%) in group A (P=0.04) and 10.0% (95% CI 4.3-15.7%) in group B (P=0.001). For T1-T2, no significant changes occurred in arthritic rabbits (group A). In conclusion, DO increased total posterior mandibular height in rabbits with arthritis. Postoperatively, no significant effect of DO was observed in rabbits with arthritis. Mandibular DO could be a viable treatment modality in patients with TMJ-arthritis.
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Affiliation(s)
- K Andersen
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
| | - T K Pedersen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark; Section of Orthodontics, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - P Svendsen
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - E M Hauge
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - S Schou
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - S E Nørholt
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry, Aarhus University, Aarhus, Denmark; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Andersen K, Pedersen TK, Hauge EM, Schou S, Nørholt SE. Effect of mandibular distraction osteogenesis on the temporomandibular joint: a systematic review of animal experimental studies. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:407-15. [DOI: 10.1016/j.oooo.2013.12.405] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/20/2013] [Accepted: 12/17/2013] [Indexed: 11/24/2022]
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Kristensen KD, Alstergren P, Stoustrup P, Küseler A, Herlin T, Pedersen TK. Cytokines in healthy temporomandibular joint synovial fluid. J Oral Rehabil 2014; 41:250-6. [PMID: 24575711 DOI: 10.1111/joor.12146] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2014] [Indexed: 11/30/2022]
Abstract
Analysis of temporomandibular joint (TMJ) synovial fluid may elucidate the aetiology of temporomandibular disorders and arthritic conditions, as well as the inflammatory mechanisms involved. Knowledge about healthy synovial fluid is necessary to understand TMJ pathologies. We aimed to quantify the proinflammatory cytokines interleukin (IL)-1β, IL-2, IL-6 and tumour necrosis factor (TNF), and the anti-inflammatory cytokines IL-10 and interferon (IFN)-γ in healthy TMJ synovial fluid to serve as reference values for future studies on TMJ pathologies. Twenty healthy, young adult volunteers without temporomandibular dysfunction were included. Bilateral synovial fluid samples were obtained using the push-pull technique with hydroxocobalamin described by Alstergren in 1999. Cytokines were quantified with Luminex multiplex assays and compared using nonparametric statistical analysis. No serious adverse effects were reported. Of 40 possible samples, 14 fulfilled the strict sampling criteria and were included in the analysis. Cytokine values (reported as medians with interquartile ranges) were as follows: TNF, 23 (13-37) pg mL(-1) ; IL-2, 1·8 (0-22) pg mL(-1) ; and INF-γ, 10 (0-47) pg mL(-1) . IL-1β, IL-6 and IL-10 were almost undetectable. In addition, TNF and INF-γ cytokine levels correlated. We demonstrated that TNF was consistently detected and IFN-γ and IL-2 sporadically detected in the TMJ synovial fluid of healthy individuals using the hydroxocobalamin method and a multiplex assay. The cytokines IL-10, IL-1β and IL-6 were barely detectable in this sample of healthy TMJs.
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Affiliation(s)
- K D Kristensen
- Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; Specialist Oral Health Center for Western Norway, Stavanger, Norway
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Stoustrup P, Kristensen KD, Küseler A, Verna C, Herlin T, Pedersen TK. Management of temporomandibular joint arthritis-related orofacial symptoms in juvenile idiopathic arthritis by the use of a stabilization splint. Scand J Rheumatol 2013; 43:137-45. [DOI: 10.3109/03009742.2013.830146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nørholt SE, Pedersen TK, Herlin T. Functional changes following distraction osteogenesis treatment of asymmetric mandibular growth deviation in unilateral juvenile idiopathic arthritis: a prospective study with long-term follow-up. Int J Oral Maxillofac Surg 2012; 42:329-36. [PMID: 23068113 DOI: 10.1016/j.ijom.2012.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 05/25/2012] [Accepted: 09/18/2012] [Indexed: 12/24/2022]
Abstract
In juvenile idiopathic arthritis (JIA), temporomandibular joint involvement is a frequent complication leading to deficient mandibular growth. Occurring unilaterally this will give rise to mandibular and maxillary asymmetry that will affect the soft tissue and the muscles and result in complex dentofacial anomaly. In the case of severe dentofacial malformation, orthognathic surgery is the only treatment option. Vertical osseodistraction of the mandibular ramus has been suggested as a means of rectifying the mandibular growth deviation and soft-tissue problems. Whether such treatment introduces dysfunctional side effects of the temporomandibular joint and muscles has been debated and concern has been raised that treatment impairs the patient's mouth opening capacity and mandibular movement. The present study prospectively evaluated 23 patients with JIA and mandibular asymmetry caused by unilateral temporomandibular joint arthritis. The authors found a clinical effect on the asymmetry with only minor subjective complaints and limited objective changes in functional parameters.
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Affiliation(s)
- S E Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus C, Denmark.
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Trainito S, Favero L, Martini G, Pedersen TK, Favero V, Herlin T, Zulian F. Odontostomatologic involvement in juvenile localised scleroderma of the face. J Paediatr Child Health 2012; 48:572-6. [PMID: 22409322 DOI: 10.1111/j.1440-1754.2012.02435.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Localised scleroderma of the face (LSF) can lead to significant aesthetical and functional abnormalities. Despite their quite frequent clinical observation, the odontostomatologic complications are not thoroughly described. Aim of the study was to describe the clinical features of the most frequent odontostomatologic abnormalities of LSF and to propose clinical and radiologic criteria for the assessment and follow-up of these complications. METHODS We performed a cross-sectional, multicenter study involving a multidisciplinary team formed by paediatric rheumatologists, orthodontists and radiologists. Patients with a diagnosis of LSF underwent a comprehensive rheumatologic evaluation, dental examination, conventional radiology (orthopantomography, teleradiography) and cone beam computed tomography. RESULTS 16 patients, nine F, seven M, aged 6.5-21.9 years, were investigated. The mean disease duration was 7.7 years, 62.5% had extracutaneous complications. All patients reported at least one odontostomatologic complication. The main alterations were: malocclusion (94%), overgrowth tendency of the anterior lower third of the face (82%), gnatologic alterations (69%), dental anomalies (63%), skeletal asymmetry (56%), bone involvement (50%) and temporomandibular joint involvement (19%). CONCLUSIONS We found a high incidence of odontostomatologic abnormalities in LSF. Cone beam computed tomography represents a new feasible technique to evaluate and monitor soft and hard tissue changes in LSF. The observed findings highlight the importance of a multidisciplinary and standardised management of this challenging and rare condition.
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Affiliation(s)
- Sabina Trainito
- Department of Pediatrics, University of Padua, Padova, Italy
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Andersen K, Nørholt SE, Küseler A, Jensen J, Pedersen TK. A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla. J Oral Maxillofac Res 2012; 3:e3. [PMID: 24422010 PMCID: PMC3886103 DOI: 10.5037/jomr.2012.3203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 06/20/2012] [Indexed: 11/28/2022]
Abstract
Objectives To compare cleft lip and palate patients' satisfaction with aesthetics and
functional parameters after conventional advancement of the maxilla or by
the use of distraction osteogenesis. Material and methods Case series observational study. Group of distraction osteogenesis (DO)
consisted of 15 patients treated with distraction osteogenesis while group
conventional (CONV) included 10 patients treated with traditional
advancement of the maxilla. Patients were asked to fill out a questionnaire
about their subjective evaluation of satisfaction with facial aesthetics and
functional parameters on a continuous visual analog-scale (VAS) when the
treatment was finished. Results The total response rate was 76%. Preoperatively the two groups did not differ
significantly according to group characteristics. At follow-up both groups
were satisfied with aesthetics and functional parameters. The DO group was
less satisfied with the duration of the treatment than the CONV group. There
were no statistically significant differences among the groups regarding
functional parameters or facial aesthetics. Conclusions Cleft lip and palate patients experienced a high level of satisfaction with
functional parameters and aesthetics as a result of surgical maxillary
advancement. The patients treated with distraction osteogenesis were less
satisfied with the duration of the treatment. Further studies are
needed.
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Affiliation(s)
- Kristian Andersen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital Aarhus Denmark. ; Department of Oral and Maxillofacial Surgery and Oral Pathology, School of Dentistry, Aarhus University Aarhus Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital Aarhus Denmark. ; Department of Oral and Maxillofacial Surgery and Oral Pathology, School of Dentistry, Aarhus University Aarhus Denmark
| | - Annelise Küseler
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital Aarhus Denmark. ; Cleft Palate Institute, Aarhus University Hospital Aarhus Denmark
| | - John Jensen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital Aarhus Denmark
| | - Thomas Klit Pedersen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital Aarhus Denmark
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Nørholt SE, Pedersen TK, Herlin T. Mandibular distraction osteogenesis in patients with unilateral TMJ involvement in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194532 DOI: 10.1186/1546-0096-9-s1-p177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nørholt SE, Jensen J, Schou S, Pedersen TK. Complications after mandibular distraction osteogenesis: a retrospective study of 131 patients. ACTA ACUST UNITED AC 2011; 111:420-7. [DOI: 10.1016/j.tripleo.2010.05.050] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 05/19/2010] [Accepted: 05/21/2010] [Indexed: 10/19/2022]
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Stoustrup P, Kristensen KD, Küseler A, Gelineck J, Cattaneo PM, Pedersen TK, Herlin T. Condylar lesions in relation to mandibular growth in untreated and intra-articular corticosteroid-treated experimental temporomandibular joint arthritis. Clin Exp Rheumatol 2010; 28:576-583. [PMID: 20810038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 03/11/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To evaluate condylar lesions in relation to mandibular growth in experimental temporomandibular joint (TMJ) arthritis and to assess the outcome of treating this condition with repeated intra-articular corticosteroid injections (IACIs). METHODS Forty-two 10-week-old rabbits were randomly divided into four groups. Seven animals served as controls. Experimental TMJ arthritis was induced in five animals which received intra-articular TMJ saline injections. Fifteen animals had TMJ arthritis induced and were left untreated and 15 animals had TMJ arthritis induced and were treated with IACIs one week after each TMJ antigen-challenge procedure. Inter-group growth differences were evaluated from head computerised tomography scans taken at the time of arthritis induction and 12 weeks later. The variables assessed were: progression of condylar lesions (erosions/flattening/osteophytes), mandibular bone volume changes, condylar and sagittal ramus growth. RESULTS No inter-group differences in the progression of condylar lesions were observed despite reduced mandibular growth in all three experimental groups. The most pronounced unfavourable mandibular growth alterations were observed in the corticosteroid-treated arthritis animals. CONCLUSIONS No evidence was found in support of a relation between reduced mandibular growth and condylar lesions. We propose that: 1) condylar lesions are not the only causative factor of reduced mandibular growth in experimental TMJ arthritis, and 2) repeated IACIs have a very unfavourable impact on mandibular growth in experimental TMJ arthritis - treatment is more detrimental to mandibular growth than the TMJ arthritis itself.
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Affiliation(s)
- P Stoustrup
- Department of Orthodontics, University of Aarhus, Denmark.
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Pedersen TK, Küseler A, Gelineck J, Herlin T. A prospective study of magnetic resonance and radiographic imaging in relation to symptoms and clinical findings of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol 2008; 35:1668-1675. [PMID: 18634141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE In patients with juvenile idiopathic arthritis (JIA) temporomandibular joint (TMJ) involvement is a common cause of severe growth disturbances. Extent of growth deviation depends on age of onset and duration of arthritis in the TMJ. TMJ arthritis is difficult to diagnose at an early stage since relatively few symptoms and clinical findings are related to this joint. The pathologic process can affect growth long before radiographic changes are seen. We investigated the relationship between TMJ arthritis and symptoms and clinical findings to suggest a clinical routine for diagnosing TMJ arthritis. We also describe the course of TMJ arthritis in relation to a commonly used radiographic method versus MRI. METHODS Fifteen children with JIA were examined 4 times at 6 month intervals for TMJ involvement by clinical examination, MRI-scanning, and orthopantomograms (OPG). At baseline, 10 healthy children served as a control group. RESULTS Patients reported more inability to chew and open their mouth than the control group. Translation of the condyle and range of mandibular movements were diminished in the arthritis group. Decreased translation was correlated to condylar changes seen on both OPG and MRI. MRI was superior to OPG in following changes of the condyle over time, and inflammation was detected in nearly all joints. CONCLUSION OPG cannot be recommended for diagnosis or to follow the course of changes in the TMJ. We advocate recording condylar translation and mandibular range of motion as a current clinical routine to find early TMJ arthritis in contrast to the often used OPG performed in our study, which was an uncertain method.
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Affiliation(s)
- Thomas Klit Pedersen
- Department of Orthodontics and Radiology, University of Aarhus, Aarhus, Denmark.
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Kristensen KD, Stoustrup P, Küseler A, Pedersen TK, Nyengaard JR, Hauge EM, Herlin T. Quantitative histological changes of repeated antigen-induced arthritis in the temporomandibular joints of rabbits treated with intra-articular corticosteroid. J Oral Pathol Med 2008; 37:437-44. [PMID: 18266658 DOI: 10.1111/j.1600-0714.2007.00630.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND To compare the inflammatory changes of antigen-induced temporomandibular joint (TMJ) arthritis in rabbits by different histological methods and to evaluate the immunomodulatory effect of intra-articular corticosteroid injections histologically. METHODS 35 rabbits (10 weeks old) pre-sensibilized with ovalbumin were divided into three groups: a placebo group of five (saline), an arthritis group of 15 (ovalbumin) and a steroid-treated group of 15 (ovalbumin + corticosteroid). Additionally, a group of seven rabbits receiving no sensibilization with ovalbumin and no intra-articular injections served as controls. Histomorphometry of the inflammatory changes in the subsynovial connective tissue (SSCT) of the TMJ included: (i) semi-quantitative (S-Q) scoring of inflammation and synovial proliferation, (ii) thickness measurements and fractional surface and (iii) stereological quantitative assessment of volume and plasma cells in thick sections of the SSCT by an optical fractionator. RESULTS The histomorphometry showed synovial proliferation in both the arthritis and the steroid groups. The plasma cell count obtained by the optical fractionator was significantly reduced when treating the TMJ with corticosteroids. However, the thickness of the synovial lining and volume of the SSCT as well as S-Q scoring of inflammation showed no difference between the arthritis and the steroid-treated groups. The optical fractionator proved a superior tool compared to S-Q assessments. CONCLUSION Counting of plasma cells in the SSCT showed that corticosteroids reduced the inflammation, but did not eliminate it. Semiquantitative scoring of synovial proliferation and inflammation demonstrated low sensitivity regarding changes in immunomodulation in antigen-induced arthritis compared to stereological quantitative estimations using an optical fractionator.
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Kofod T, Pedersen TK, Nørholt SE, Jensen J. Stereolithographic models for simulation and transfer of vector in vertical distraction of the mandibular ramus: a technical note. J Craniofac Surg 2005; 16:608-14. [PMID: 16077305 DOI: 10.1097/01.scs.0000147391.83745.5c?] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mandibular distraction osteogenesis is, despite impressive results, compromised as a treatment modality by difficulties with vector control independent of whether intra- or extraoral devices are used. Resistance of the masticatory muscles and the remaining soft tissue envelope toward elongation and incorrect planning and transfer of the vector cause lack of vector control. To ensure predictability in correct placement of intraoral distraction devices and thereby treatment outcome, a combined planning, simulation, and transfer method was developed. The purpose of the simulation and transfer technique is to duplicate the planned and simulated position and orientation of the distraction device during surgery. The preoperative plan is based on frontal and lateral head films, and the planned position and orientation of the distraction apparatus was applied on the stereolithographic model. The model was cut according to the planned osteotomy, and the distraction was simulated on the stereolithographic model. Based on plaster models transferred to the stereolithographic model, an individual guiding splint was fabricated to reproduce the planned and simulated distraction treatment in the patient. The details of the simulation and transfer technique are presented and discussed in two cases.
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Affiliation(s)
- Thomas Kofod
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
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Abstract
Successful correction of facial asymmetry by mandibular distraction osteogenesis relies on mastering vector control. Lack of necessary vector control continues to compromise the treatment modality. The purpose of this study was to describe a new simplified method for vector transfer and to evaluate this method according to the outcome and the efficacy of distraction osteogenesis in the correction of unilateral mandibular hypoplasia and asymmetry. Twenty-seven patients with unilateral hypoplasia of the mandibular ramus underwent unilateral mandibular distraction osteogenesis with intraoral distraction devices. Posterior-anterior and lateral cephalograms were analyzed by digitalization. Changes in sagittal, vertical, and transversal linear and angular dimensions after the distraction treatment were evaluated by measurements performed on headfilms taken before and after surgery. Means and variances were calculated for selected cephalometric variables for each time point. The differences between the control and the treatment side were calculated, statistically described, and compared with a paired Student t test. Correction of the mandibular asymmetry, chin position, and the canting of the occlusal plane was obtained in all patients clinically, as well as radiographically, by the use of intraoral unidirectional distraction osteogenesis.
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Affiliation(s)
- Thomas Kofod
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Noerrebrogade 44, Bygn 9D, DK-8000 Aarhus C, Denmark.
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Küseler A, Pedersen TK, Gelineck J, Herlin T. A 2 year followup study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol 2005; 32:162-9. [PMID: 15630742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE Involvement of the temporomandibular joint (TMJ) in patients with juvenile idiopathic arthritis (JIA) can cause severe craniofacial growth disturbances if not treated in the initial stage. Magnetic resonance imaging (MRI) is an efficient method for detecting early inflammatory changes of the TMJ. We investigated correlation between findings from the clinical examination with MRI of the TMJ, and describe development of the MR image over time. METHODS Fifteen children with newly diagnosed JIA (mean age 12.0 yrs) were examined clinically and with MRI enhanced with Gd-DTPA 4 times at 6-8 month intervals. Clinical and MRI findings were scored. MRI variables included T1 weighted images before and after administration of Gd-DTPA with and without fat suppression. RESULTS A total of 115 joints were examined during the 2 year period: 93% showed enhancement, 71% condylar erosions, 26% pannus, and 23% joint fluid accumulation of the TMJ. In all except one child, one or both TMJ showed enhancement of the synovial membrane during the examination period. Symptoms were rare. All patients showing mild to severe findings by clinical examination also had pathological signs on the enhanced MRI, but not all patients without clinical findings had a normal MRI. CONCLUSION TMJ involvement in patients with JIA is very common, and MRI findings such as synovial enhancement, pannus, and joint fluid fluctuate over time. The clinical examination may be used as a filter, where children showing no clinical signs could be selected for enhanced MRI.
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Affiliation(s)
- Annelise Küseler
- Department of Orthodontics, the Paediatric Rheumatology Clinic, University of Aarhus, Aarhus, Denmark
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