Dental and facial characteristics of patients with juvenile idiopathic arthritis

Abstract

OBJECTIVE: It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital. METHOD: Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children. RESULTS: The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P = .032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P = .055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P = .017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P = .015). CONCLUSION: This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health.

Periodontal disease in pediatric rheumatic diseases

“…8 In this regard, chronic arthritis with upper limb disability and reduced mandibular mobility due to temporomadibular joint involvement was reported to be an important contributing factor for PD in our JIA patients. 32 Furthermore, a signifi cant increased level of poor oral hygiene in patients with JIA was found. 35 On the other hand, one study showed that if cofactors (such as: age, gender and smoking) are included, the microbial plaque (and not the JIA diagnosis) is related to periodontitis.…”

“…[28][29][30] Several studies, [29][30][31][32][33][34] reporting that JIA could be a risk factor for gingivitis or periodontitis and these pediatric conditions were included in the current system classifi cation of PD. 8 In this regard, chronic arthritis with upper limb disability and reduced mandibular mobility due to temporomadibular joint involvement was reported to be an important contributing factor for PD in our JIA patients.…”

“…Despite the immunosuppressive treatment, the majority of JIA patients presented mild gingivitis without loss of connective tissue attachment, and periodontitis was rarely described. 32,37,55 In addition, JIA patients under anti-TNF blockage had a higher frequency of sites with increased probing depth and a lower frequency of sites with bleeding on probing, 56 however experimental studies suggested that these drugs might inhibit radiographic progression. 57 …”

Etiology of Open‐Bite Malocclusion

“…Juvenile rheumatoid arthritis is a disease with oral involvement with anterior open bite, limited mouth opening, and in most of the cases, compromises the temporomandibular joint (Savioli et al 2004;Carvalho et al 2012) …”

Avaliação de parâmetros do metabolismo ósseo e da saúde oral em pacientes com lúpus eritematoso sistêmico juvenil

“…Sendo assim, novos aspectos devem ser considerados no acompanhamento destes pacientes, tais como o comprometimento da massa óssea e alterações da saúde oral, que podem estar associadas ao processo inflamatório decorrente da atividade da doença e/ou do uso crônico de glicocorticoides (GC) e imunossupressores [8][9][10][11] .…”