RT Journal Article
SR Electronic
T1 Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.190231
DO 10.3899/jrheum.190231
A1 Mia Glerup
A1 Peter Stoustrup
A1 Louise Hauge
A1 Veronika Rypdal
A1 Ellen Nordal
A1 Paula Frid
A1 Ellen Dalen  Arnstad
A1 Marite Rygg
A1 Olafur Thorarensen
A1 Maria Ekelund
A1 Lillemor Berntson
A1 Anders Fasth
A1 Håkan Nilsson
A1 Suvi Peltoniemi
A1 Kristiina Aalto
A1 Sirpa Arte
A1 Peter Toftedal
A1 Susan Nielsen
A1 Sven Kreiborg
A1 Troels Herlin
A1 Thomas Klit  Pedersen
YR 2019
UL http://www.jrheum.org/content/early/2019/09/11/jrheum.190231.abstract
AB 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 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface 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 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one 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. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the 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 first study on long-term 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 follow-up of JIA patients also in adulthood.