Clinical and Instrumental TMJ Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Case—Control Study

Abstract

To investigate temporomandibular joint (TMJ) involvement signs such as muscle pain, the ratio of masseter and temporal muscle activity, mouth opening width and jaw deviation during mouth opening in children and adolescents with juvenile idiopathic arthritis (JIA), a group of 32 subjects with JIA and a control group of 32 healthy subjects were evaluated. Data were collected clinically by muscle palpation (masseters, anterior temporalis and sternocleidomastoids) and instrumental analysis (electromyography and kinesiography). Higher pain was registered in the masseter and sternocleidomastoid muscles on both sides and in the right anterior temporalis in the JIA group compared to the control group (p < 0.05). Electromyography showed no statistically significant difference in the frequency of the pathological ratio of masseter and temporal muscle activity (MM/TA < 1) both in the JIA group and in the control group. Kinesiography showed a statistically significant difference in mouth opening width and jaw deviation during mouth opening between the groups (p < 0.05): JIA subjects showed lower mouth opening values and wider deviation on mouth opening; 29 out of 32 JIA subjects showed jaw deviation towards the right side. JIA affects the TMJ, causing myalgia in the head and neck muscles, a reduction in mouth opening width and an increase in jaw deviation during mouth opening.

Clinical and Instrumental Temporomandibular Joint Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Medium-Term Follow-Up

“…The results obtained from the interpretation of muscle palpation data suggest that the conditions of masticatory muscles for JIA patients and healthy controls are similar, except for the sternocleidomastoid muscle group, which shows increased pain that persists over time. The same statistical evidence at the SCM level was found by D'Attilio et al in a study conducted at G. D'Annunzio University in 2019 [18]. As suggested by Tanaka, the sternocleidomastoid is a postural muscle conditioning the balance of the muscles of the stomatognathic system [40].…”

“…The Teethan BTS TTMJOINT (SpA, Garbagnate Milanese, Italy, https://teethan.com/teethan-software/) software was used for the study, and a wireless surface electromyograph (EMG) was used to record the electrical activity of a muscle during its contractile activity with the use of six pairs of pre-gelled electrodes in order to process the data and graphically represent the biological phenomenon of contraction. Further information is available about the functioning of the electromyograph in the study by D'Attilio et al [18]. Following the main orientation of the muscular fibers, the electrodes were positioned on the belly of the sternocleidomastoid (SCM), superficial masseter (MM), and anterior temporalis (TA) of the left and right sides.…”

“…From an orthodontic perspective, TMJ arthritis can severely impact sagittal and vetical jaw growth, causing micrognathia and an open bite with aesthetic and functional consequences [12]. From a muscular point of view, myalgia in the head and neck muscles may occur due to untreated TMJ involvement; pain mainly occurs during mouth opening and mastication, mainly in the articular area and in the masseter area [18][19][20][21]. Early detection of TMJ disorders in JIA patients is crucial to prevent future facial growth and dental problems, moderate the TMJ damage, and increase the patients' quality of life [22].…”

Pain Assessment during Gnathological Treatment of Temporomandibular Myofascial Pain through Mandibular Repositioning Splints Designed after a Posture-Stabilometric Evaluation

“…Myofascial pain is the most common TMD and its etiology is multifactorial. Several therapies and appliances have been developed to try to diagnose it and relieve the associated symptoms [34,35]. Reversible treatments should be preferred to invasive procedures (i.e., occlusal adjustment, through selective grinding of the tooth surfaces) for the rehabilitation of patients with myofascial disease, and generally for TMD [14,36].…”

Sandwich Integration Technique for the Pressure Sensor Detection of Occlusal Force In Vitro

“…The other various measurement devices are mostly highlighted in experimental studies and warranted further clinical validation [ 11 ]. Meanwhile, electromyography has been reported in recently published research as a possible technique for bite force registration [ 12 ]. However, the previous research was mainly focused on bite force detection, and there is a lack of in-depth research on how to control these abnormal forces during functional performance in real time.…”