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Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis - an observational study
Department of Behavioral and Community Dentistry, University of Gothenburg, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Department of Orthodontics, Eastman Institutet, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Pediatrisk inflammationsforskning/Nevéus)
Department of Dental Medicine, Section for Orofacial Pain and Jaw Function, Karolinska Institutet, Huddinge, Sweden.
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2013 (English)In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 11, no 1, 37- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease that frequently affects also the temporomandibular joint (TMJ) and associated structures. The main aim of this observational study was to describe systematically orofacial clinical signs and subjective symptoms in JIA patients, classified according to the International League of Associations for Rheumatology (ILAR) criteria, and to relate the findings to disease activity and radiological TMJ condyle lesions.

METHODS: The study was a retrospective evaluation of dental and medical records in consecutive JIA patients referred to one of three dental specialist clinics in Sweden during an eight-year period. Data concerning temporomandibular signs, symptoms and general disease activity were collected and condylar alterations were judged on panoramic radiographs.

RESULTS: All ILAR categories of JIA were represented among the 266 referrals included in the study. The distribution of patients among categories resembled the pattern seen in epidemiological studies. Persistent oligoarthritis was the largest category with 36.5 % of the patients. Temporomandibular clinical signs (mild, moderate or severe) occurred in 57.7 % to 92.0 %, and subjective symptoms (mild or severe) in 32.0 % to 76.0 % of the patients in all categories. Patients in the juvenile psoriatic arthritis category had the largest number of orofacial signs and symptoms, and patients in the persistent oligoarthritis category had the fewest signs and symptoms. There were significant associations between clinical signs as well as subjective symptoms and overall disease activity. Half of all the patients had undergone panoramic examinations and 37.9 % of those were judged to have condylar alterations after a mean of 2.9 years after onset. No associations between radiological findings and variables, such as signs, symptoms or disease activity, were found.

CONCLUSIONS: Temporomandibular signs and symptoms can be expected to a varying degree, including severe cases, in all JIA categories. Clinical and subjective orofacial involvement appears to be related to disease activity but not to condylar lesions.

Place, publisher, year, edition, pages
2013. Vol. 11, no 1, 37- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-214988DOI: 10.1186/1546-0096-11-37ISI: 000328820900001PubMedID: 24134193OAI: oai:DiVA.org:uu-214988DiVA: diva2:685848
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2016-04-21Bibliographically approved

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Berntson, Lillemor
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Oral and Maxillofacial SurgeryDepartment of Women's and Children's Health
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