Challenging the silent temporomandibular joint paradigm in children with juvenile idiopathic arthritis

Chew on This: The Afterbite of Temporomandibular Joint Involvement in Adults With Juvenile Idiopathic Arthritis

“…12 They found that AMIO was 8.8 mm (95% CI −11.40 to −6.12; P < 0.001) lower in adults with JIA and concurrent TMJ disease compared to adults with JIA without TMJ disease, suggesting that AMIO is a helpful measuring tool to detect TMJ involvement in this population. 12 AVBF was not found to be statistically significant to distinguish TMJ involvement in adults with JIA. Therefore, the AMIO as a measurement tool may help tailor further assessment pathways, such as referrals to multidisciplinary dental teams, and aid in determining the need for MRI, especially in areas where these resources are limited.…”

“…In this issue of The Journal of Rheumatology, de Sonnaville et al, in a cross-sectional study of 100 adults with JIA and 59 healthy controls, studied clinical variables that indicated TMJ involvement in adult patients with JIA. 12 Although MRI with contrast is the undisputed gold standard for diagnosis and monitoring of TMJ arthritis, 3,13 it can be costly and difficult to access as a standard of care. De Sonnaville et al used clinical features and measurement tools comparing adults with JIA with TMJ disease (56% of the cohort) to adults with JIA and no TMJ disease, and to healthy controls, to see if these measurements could aid in determining TMJ involvement in adults with JIA.…”

“…Clinical features, such as crepitation (50%), deviation during mouth opening (48%), asymmetry (39%), and retrognathia (39%), were most often associated with TMJ disease in patients with adult JIA. 12 The importance of screening TMJ in patients with JIA is emphasized in the study by de Sonnaville et al as they offer alternatives to MRI that can be completed in a routine clinical visit. 12 De Sonnaville et al used active maximum incisor opening (AMIO) and anterior maximum voluntary bite force (AVBF) as objective measures to routinely screen for TMJ involvement, in addition to history and clinical examination.…”

“…12 The importance of screening TMJ in patients with JIA is emphasized in the study by de Sonnaville et al as they offer alternatives to MRI that can be completed in a routine clinical visit. 12 De Sonnaville et al used active maximum incisor opening (AMIO) and anterior maximum voluntary bite force (AVBF) as objective measures to routinely screen for TMJ involvement, in addition to history and clinical examination. 12 They found that AMIO was 8.8 mm (95% CI −11.40 to −6.12; P < 0.001) lower in adults with JIA and concurrent TMJ disease compared to adults with JIA without TMJ disease, suggesting that AMIO is a helpful measuring tool to detect TMJ involvement in this population.…”

“…12 De Sonnaville et al used active maximum incisor opening (AMIO) and anterior maximum voluntary bite force (AVBF) as objective measures to routinely screen for TMJ involvement, in addition to history and clinical examination. 12 They found that AMIO was 8.8 mm (95% CI −11.40 to −6.12; P < 0.001) lower in adults with JIA and concurrent TMJ disease compared to adults with JIA without TMJ disease, suggesting that AMIO is a helpful measuring tool to detect TMJ involvement in this population. 12 AVBF was not found to be statistically significant to distinguish TMJ involvement in adults with JIA.…”