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Ultrasound Screening of Temporomandibular Joint Pathology in Children with Chronic Kidney Disease
Natalia Sergeevna Morozova1, Alina Alekseevna Elovskaya2, Ekaterina Andreevna Maslikova2
1Department of Dental Diseases Propaedeutics, E.V. Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 117418 Moscow, Russia.
Insights
Children with chronic kidney disease (CKD) exhibit temporomandibular joint (TMJ) changes. Ultrasound can detect these TMJ abnormalities in pediatric CKD patients, enabling early dental intervention and rehabilitation.
Area of Science:
- Pediatric Nephrology
- Radiology
- Dentistry
- Orthodontics
Background:
- Chronic kidney disease (CKD) is known to affect various organs, including the temporomandibular joint (TMJ).
- Early identification of TMJ alterations in children with CKD is crucial for timely management.
- Ultrasound offers a non-invasive and accessible imaging modality for TMJ assessment.
Purpose of the Study:
- To investigate structural and functional changes in the temporomandibular joint (TMJ) of children with chronic kidney disease (CKD).
- To evaluate the utility of ultrasound in detecting TMJ abnormalities in pediatric CKD patients.
Main Methods:
- Ultrasound screening of the temporomandibular joint (TMJ) was performed on 40 children.
- Participants were divided into four groups: healthy controls, children with early-stage CKD (stages 1-2), patients on hemodialysis post-transplantation, and patients at least 6 months post-transplantation.
- Quantitative measurements of TMJ gap dimensions and assessment of disc displacement were conducted.
Main Results:
- Statistically significant differences in TMJ gap size were observed, particularly in the anterior and middle sections of the right TMJ in children undergoing hemodialysis post-transplantation compared to controls.
- Significant differences in TMJ gap width were also found across all sections of the left TMJ between the study groups.
- The frequency of anterior disc displacement was high across all groups, with no statistically significant difference between them.
Conclusions:
- Children with chronic kidney disease (CKD) demonstrate distinct temporomandibular joint (TMJ) changes.
- Temporomandibular joint (TMJ) ultrasound is a valuable tool for screening and early detection of joint pathology in pediatric CKD patients.
- Early detection facilitates timely intervention and rehabilitation by dental specialists.
Abstract:
Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were examined using ultrasound screening in 40 children. The first group (control, n = 10) included children with normal occlusion without TMJ complaints. The second group (n = 10) included children with CKD stage 1 and 2. The third group (n = 10) included patients on hemodialysis after renal transplantation. The forth group (n = 10) included patients at least 6 months after renal transplantation. Results: The size of the anterior section of the right TMJ gap in the third group was the largest among all the groups studied (1.085 mm) and statistically significantly different from the first group (0.570 mm; p = 0.001) and the second one (0.665 mm, p = 0.001). The width of the middle section was also greatest in the third group and statistically significantly different when compared to the first and second groups (0.390 mm; p = 0.023 and 0.340 mm; p < 0.001, respectively). A posterior articular gap width differences between the individual patient groups under study were not statistically significant in a posteriori comparison with Bonferroni correction. Statistical significance of differences between all groups when comparing the gap width was found in all sections of the left TMJ. The frequency of anterior disc displacement between groups ranged from 50 to 100% in all groups studied and was not statistically different when comparing right and left TMJs between groups (p = 0.084 and p = 0.662, respectively). Conclusions: CKD children have different TMJ changes, so TMJ ultrasound could screen joint pathology at early stages, and dental specialists can start timely rehabilitation.
