Bifocal Distraction in Patient with Rheumatoid Arthritis and Severe Condylar Degeneration. Report of Case

Facial involvement in patients with rheumatoid arthritis is variable depending on the type, onset, and duration of the disease. The treatment of patients with open bite resulting from degenerative changes on the condyles can be a challenge for the surgeon. Rheumatoid arthritis is a systemic disorder of unknown etiology characterized by chronic inflammation and proliferation of synovial tissue. Studies showed that patients with rheumatoid arthritis can developed progressive osteoarthrosis that result in gross radiographic changes in the condyles. With the development of distraction osteogenesis for treatment of mandible hypoplasia a new chapter has been opened in the surgical management of patients with rheumatoid arthritis associated with skeletal deficiency. The aim of this paper is to evaluate osteogenesis distraction for treatment of anterior open bite in patients with rheumatoid arthritis and severe condylar degeneration.