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

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.

Temporomandibular joint diagnostics using CBCT

“…69 It is well known that symptoms and clinical signs of TMJ involvement may be subtle, making imaging an important diagnostic tool. [75][76][77] Some CBCT studies of patients with JIA are available. A clinical evaluation according to the research diagnostic/TMD criteria 78 revealed only a few of the patients with JIA with TMJ bone abnormalities on CBCT.…”

Long-term Follow-up of Craniofacial Alterations in Juvenile Idiopathic Arthritis

“…The reported frequency of TMJ involvement ranges in the literature from 17% to 87%, depending on the population investigated, the subtypes represented, and the radiologic method by which involvement is diagnosed. [5][6][7][8][9][10][11][12][13][14] Only one study reported the incidence of TMJ involvement in all subtypes of JIA. 6 The most important site of growth of the mandible in the vertical and sagittal direction is located on the articular surface of the condylar head.…”

“…6 A drastic decrease in the prevalence of OPT alterations was observed during follow-up. 6,7 The aim of this survey was to study how the course of condylar alterations can influence the craniofacial skeleton in patients with JIA over a 5-year period.…”

How important is early magnetic resonance imaging of the temporomandibular joint for the treatment of children with juvenile idiopathic arthritis: a retrospective analysis

“…Pedersen et al [30] performed repeated TMJ MRI in 15 JIA patients prospectively 4 times within 2 years and found that nearly all had inflammatory signs at some point in time. Interestingly, on long-term follow-up improvement as well as worsening of the condylar shape have been demonstrated [33,34]. Why a presumably undulating inflammatory process will lead to progressive destruction in some patients but allows condylar remodelling in others remains unclear so far.…”