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Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis.

Journal article
Authors Mia Glerup
Peter Stoustrup
Louise Hauge
Veronika Rypdal
Ellen Nordal
Paula Frid
Ellen Dalen Arnstad
Marite Rygg
Olafur Thorarensen
Maria Ekelund
Lillemor Berntson
Anders Fasth
Håkan Nilsson
Suvi Peltoniemi
Kristiina Aalto
Sirpa Arte
Peter Toftedal
Susan Nielsen
Sven Kreiborg
Troels Herlin
Thomas Klit Pedersen
Published in The Journal of rheumatology
ISSN 0315-162X
Publication year 2019
Published at Institute of Clinical Sciences, Department of Pediatrics
Language en
Subject categories Pediatrics, Rheumatology and Autoimmunity


To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the JIA. The mean maximal incisal opening was lower in the JIA group (p<0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.This first study on long-term consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary follow-up of JIA patients also in adulthood.

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