Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis

Arthritis Rheum. 2008 Apr 15;59(4):546-52. doi: 10.1002/art.23532.

Abstract

Objective: Temporomandibular joint (TMJ) involvement is a frequent feature in cross-sectional prevalence studies among patients with juvenile idiopathic arthritis (JIA). In this followup study, patients were reviewed after 5 years to study the course of TMJ involvement in relation to disease characteristics.

Methods: Children with JIA from a previous study on TMJ involvement were included. A rheumatologic evaluation including the 6 parameters of the JIA core set and an orthodontic evaluation including an orthopantomogram (OPT) were performed. OPTs were scored according to Rohlin's grading system (grades 0-5).

Results: The overall prevalence of patients with condylar alterations decreased from 49% to 40%. Improvement of the alterations was seen in 69% of the initially affected condyles, and consequently improvement was seen in 83% of the initially affected patients. Normalization of the alterations was seen in 67% of the improved condyles, and consequently in 44% of the patients. This proves that the condyle has a regenerative capacity. Improvement was related to low disease activity and a less extensive therapeutic regimen.

Conclusion: In patients with JIA, condylar alterations can improve and even regenerate. Condylar improvement is associated with a low disease activity.

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Juvenile / complications*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Temporomandibular Joint Disorders / etiology*
  • Time Factors