Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and maxillofacial radiologyRadiographic TMJ abnormalities in patients with juvenile idiopathic arthritis followed for 27 years
Section snippets
Materials and Methods
The study was approved by the Regional Committee for Medical Research Ethics, Southern Norway, and informed consent was given for all subjects.
A group of 103 children with JIA was examined between 1976 and 1979,7 and reexamined 2 and 4 years after baseline. At each examination, similar radiographic methods for the TMJs were used; namely, panoramic and lateral transcranial radiography in closed and open mouth positions, occasionally supplemented by conventional lateral tomography.14
Between 2002
Results
In the analysis of the 64 healthy individuals, the condyles stayed rounded during growth and, although they did change somewhat in shape and size, they did not flatten. Occasionally, a slightly flattened condyle persisted as such (Fig. 2).
In the 60 JIA subjects, 25 (42%) had bone abnormalities in 1 or both TMJs at baseline (Fig. 3). The frequency of cumulative TMJ abnormalities increased to 34 subjects (57%) at first reexamination, to 37 (67%) at second examination, and to 45 (75%) at the final
Discussion
The present study is unusual in following JIA patients from childhood into adulthood with comprehensive, radiographic TMJ evaluations, using healthy individuals as controls.
The facial growth archives at the University of Oslo offer a unique opportunity to demonstrate that the mandibular condyle on the panoramic image has a rounded articular surface during growth in healthy individuals. The authors found a variety of shapes, but the condyle never changed from rounded to flattened. However, a few
Conclusions
Most JIA subjects in this long-term study developed radiographic TMJ abnormalities, predominantly involving both TMJs. In the vast majority, these joints were involved before the 15th birthday, and in more than half before the pubertal growth spurt. A more severe disease course led to more frequent and more severe TMJ involvement. Progression of the radiographic TMJ abnormalities was the most frequent course, but a small group clearly showed improvement toward normalization. The high frequency
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