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Temporomandibular joint involvement in children with juvenile idiopathic arthritis: A single tertiary-center

Jubran T Alqanatish1, Banan S Alrewaithi1, Wafaa M Alsewairi1

  • 1From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia.

Saudi Medical Journal
|April 2, 2021
PubMed

Insights

Juvenile idiopathic arthritis (JIA) can affect the temporomandibular joint (TMJ). Females with polyarticular JIA are more prone to TMJ arthritis, necessitating early intervention to prevent complications.

Area of Science:

  • Pediatric Rheumatology
  • Orthodontics
  • Immunology

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease affecting children.
  • Temporomandibular joint (TMJ) involvement is a potential complication of JIA, impacting facial growth and function.
  • Understanding the characteristics and risk factors of TMJ involvement in JIA is crucial for timely management.

Purpose of the Study:

  • To characterize clinical and laboratory features of JIA patients.
  • To determine the prevalence and patterns of TMJ involvement in a cohort of JIA patients.
  • To identify potential risk factors and protective factors associated with TMJ arthritis in JIA.

Main Methods:

  • Retrospective cross-sectional study of 123 JIA patients (2015-2019) at a tertiary center.
  • TMJ involvement diagnosed via clinical examination or contrast-enhanced MRI.
  • Descriptive analysis of patient demographics, JIA subtypes, laboratory markers, and TMJ status.

Main Results:

  • 16% of JIA patients exhibited TMJ involvement, predominantly in those with Polyarticular JIA (45% of affected cases).
  • Positive antinuclear antibody (ANA) was associated with increased TMJ involvement risk.
  • Rheumatoid factor was positive in 25% of patients; HLAB27 was negative in all cases.

Conclusions:

  • Temporomandibular joint (TMJ) arthritis is a significant concern in Juvenile Idiopathic Arthritis (JIA), particularly in females with polyarticular disease.
  • Early detection and treatment of TMJ arthritis are vital to mitigate complications like micrognathia and obstructive sleep apnea.
  • Positive ANA may indicate a higher risk for TMJ involvement, while HLAB27 positivity might offer a protective effect.
Abstract

Keywords:
Saudi Arabiachildrenjuvenile idiopathic arthritistemporomandibular joint

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