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Temporomandibular joint involvement in children with juvenile idiopathic arthritis: a preliminary report

Shelly Abramowicz1, Joshua M Levy2, Sampath Prahalad3

  • 1Division of Oral and Maxillofacial Surgery, Departments of Surgery and Pediatrics, Emory University School of Medicine and Associate Chief, Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA, USA.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
|August 22, 2018
PubMed

Insights

Juvenile idiopathic arthritis (JIA) can affect the temporomandibular joint (TMJ). In a single center study, 10% of JIA patients had TMJ arthritis, with specific patient characteristics indicating higher risk.

Area of Science:

  • Pediatric Rheumatology
  • Orthodontics
  • Oral and Maxillofacial Surgery

Background:

  • Juvenile idiopathic arthritis (JIA) poses a risk for temporomandibular joint (TMJ) arthritis in children.
  • TMJ arthritis can result in significant complications, including pain, restricted jaw movement, facial asymmetry, and malocclusion.

Purpose of the Study:

  • To characterize the demographic and clinical features of pediatric patients diagnosed with JIA and concurrent TMJ involvement.
  • To identify specific subtypes and characteristics of JIA patients at higher risk for developing TMJ arthritis.

Main Methods:

  • A retrospective analysis was conducted on pediatric patients with confirmed JIA and reported jaw complaints at a single tertiary care center.
  • Data collected included patient demographics, JIA subtype, age of TMJ symptom onset, and involvement of other joints. Descriptive statistics were used for analysis.

Main Results:

  • The study cohort comprised predominantly white patients (mean age 13 years) with polyarticular rheumatoid factor (RF) negative or oligoarticular persistent JIA.
  • A significant proportion of patients exhibited involvement in other joints, such as fingers and knees.
  • Out of the patients presenting with TMJ symptoms, 10% were diagnosed with TMJ arthritis.

Conclusions:

  • In the studied cohort, 10% of JIA patients were diagnosed with TMJ arthritis.
  • Factors associated with an increased likelihood of TMJ symptoms in JIA patients include being female, white, RF-negative, HLA-B27-negative, ANA-negative, having the polyarticular RF-negative subtype, and experiencing involvement of other joints.
  • Clinical vigilance for TMJ involvement is recommended in JIA patients exhibiting these identified risk factors.
Abstract

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