scholarly journals In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Fischer ◽  
T. A. Augdal ◽  
O. Angenete ◽  
E. G. Gil ◽  
M. S. Skeie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Imaging Features ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
Radiographic Findings ◽  
Jaw Movement ◽  
Significant Difference ◽  
Tmj Pain

Abstract Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from temporomandibular disorder (TMD). Due to this, imaging diagnosis is crucial in JIA with non-symptomatic TM joint (TMJ) involvement. The aim of the study was to examine the association between clinical TMD signs/symptoms and cone-beam computed tomography (CBCT) findings of TMJ structural deformities in children and adolescents with JIA. Methods This cross-sectional study is part of a longitudinal prospective multi-centre study performed from 2015–2020, including 228 children and adolescents aged 4–16 years diagnosed with JIA, according to the International League of Associations for Rheumatology (ILAR). For this sub-study, we included the Bergen cohort of 72 patients (32 female, median age 13.1 years, median duration of JIA 4.5 years). Clinical TMD signs/symptoms were registered as pain on palpation, pain on jaw movement, and combined pain of those two. The severity of TMJ deformity was classified as sound (no deformity), mild, or moderate/severe according to the radiographic findings of CBCT. Results Of 72 patients, 21 (29.2%) had pain on palpation at and around the lateral pole, while 41 (56.9%) had TMJ pain upon jaw movement and 26 (36.1%) had pain from both. Of 141 TMJs, 18.4% had mild and 14.2% had moderate/severe structural deformities visible on CBCT. CBCT findings were not significantly associated with either the pain on palpation or the pain on jaw movement. A significant difference was found between structural deformities in CBCT and the combined pain outcome (pain at both palpation and movement) for both TMJs for the persistent oligoarticular subtype (p = 0.031). Conclusions There was no association between painful TMD and CBCT imaging features of the TMJ in patients with JIA, but the oligoarticular subtype of JIA, there was a significant difference associated with TMJ pain and structural CBCT deformities.

scholarly journals Prevalence of Temporomandibular Disorder in children and adolescents with Juvenile Idiopathic Arthritis – a Norwegian cross sectional multicenter study

2020 ◽  
Author(s):  
Johannes Fischer ◽  
Marit Slåttelid Skeie ◽  
Karen Rosendahl ◽  
Karin Tylleskär ◽  
Stein Atle Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Multicenter Study ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Health Examination ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Jaw Movement

Abstract Background. Children and adolescents with JIA may suffer pain from temporomandibular disorder (TMD) and routines for the assessment of temporomandibular joint (TMJ) pain for the health and dental care are lacking. The aims were to examine the prevalence of TMD in children and adolescents with juvenile idiopathic arthritis (JIA) as compared to their healthy peers and to examine potential associations between JIA and TMD.Methods. This comparative cross-sectional study is part of a longitudinal multicenter study performed during 2015 - 2020, including 228 children and adolescents aged 4-16 years, with a diagnosis of JIA according to the ILAR criteria. This sub-study draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Participants with JIA were matched with healthy controls according to gender, age, and center site. Calibrated examiners performed the clinical oral examinations according to a standardized protocol, including shortened versions of diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJ`s.Results. In our cohort of 221 participants with JIA and corresponding controls, 88 participants with JIA (39.8%) and 25 (11.3%) controls revealed TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p<0.001). Vertical unassisted jaw movement was lower in JIA than in controls; mean 46.2 mm vs. 49.0 mm, respectively (p <0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs (sDMARDs) and biologic (bDMARDs) presented with painful masticatory muscle and TMJs at palpation.Conclusion. Symptoms or clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in JIA.

scholarly journals Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis – a Norwegian cross- sectional multicentre study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Fischer ◽  
M. S. Skeie ◽  
K. Rosendahl ◽  
K. Tylleskär ◽  
S. Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Healthy Controls ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying

Abstract Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p <  0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p <  0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation. Conclusion Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

scholarly journals Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis – a Norwegian cross-sectional multicentre study

2020 ◽  
Author(s):  
Johannes Fischer ◽  
Marit Slåttelid Skeie ◽  
Karen Rosendahl ◽  
Karin Tylleskär ◽  
Stein Atle Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Healthy Controls ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying

Abstract Background. Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods. This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results. In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthycontrols presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p < 0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p < 0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation.Conclusion. Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

scholarly journals AB1334-HPR BARRIERS AND FACILITATORS TO PHYSICAL ACTIVITY IN JUVENILE IDIOPATHIC ARTHRITIS (JIA): A SCOPING REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1955.2-1955
Author(s):  
K. O Donoghue ◽  
L. Larkin
Keyword(s):  
Physical Activity ◽  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Scoping Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Barriers And Facilitators ◽  
Activity Levels ◽  
Cross Sectional ◽  
Common Barriers

Background:Physical activity is an important aspect in the management of JIA (1). However physical activity levels are low in this population (2). Limited research has been conducted to identify definitive barriers and facilitators to physical activity in children and adolescents who have JIA.Objectives:The objective of this scoping review was to identify the common barriers and facilitators to physical activity in JIA.Methods:Original studies, either quantitative or qualitative, including participants with a diagnosis of JIA, who were under 18 years of age were included. Two independent reviewers carried out a search of the literature and full text reviews of papers to determine eligibility for inclusion. The Critical Skills Appraisal Programme (CASP), Appraisal tool for Cross-Sectional Studies (AXIS) and Downs and Black critical appraisal tools were used to assess the quality of the included research articles.Results:Eighteen studies were included in the review. The included studies were of a variety of low, moderate and high quality. The synthesis of the data identified pain to be the most common barrier and the modification of physical activities to the need of the individual to be the most common facilitator to physical activity in JIA.Conclusion:Identifying the most common barriers and facilitators to physical activity allows clinicians to apply better management strategies when treating an individual with JIA. Our findings demonstrate the need for further research in this area to assist increasing physical activity participation for children and adolescents who have JIA.References:[1]Kuntze, G., Nesbitt, C., Whittaker, J.L., Nettel-Aguirre, A., Toomey, C., Esau, S., Doyle-Baker, P.K., Shank, J., Brooks, J., Benseler, S., Emery, C.A. (2018) ‘Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis’,Archives of Physical Medicine and Rehabilitation, 99(1), 178-193[2]Bos, G.J.F.J., Lelieveld, O.T.H.M., Armbrust, W., Sauer, P.J.J., Geertzen, J.H.B., Dijkstra, P.U. (2016) ‘Physical activity in children with Juvenile Idiopathic Arthritis compared to controls’, Pediatric Rheumatology, 14(1), 42.Disclosure of Interests:None declared

scholarly journals Gender differences in treatments and interventions received by children and adolescents with cerebral palsy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Annika Lundkvist Josenby ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Gender Differences ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Classification System ◽  
Nordic Countries ◽  
Place Of Birth ◽  
Swedish Population ◽  
Cross Sectional ◽  
National Quality ◽  
Significant Difference

Abstract Background In the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status, have the right to receive healthcare and medical treatments as applicable. Previous research has shown gender differences in treatments and interventions received by children with cerebral palsy (CP). The purpose of this study was to examine differences in treatments and interventions by gender and place of birth in children and adolescents participating in CPUP. Methods This was a cross-sectional registry study. Data from the latest PT (n = 2635) and OT assessment forms (n = 3480) in CPUP were extracted for individuals aged 0–17 years. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender X place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions and Manual Ability Classification System (MACS) for OT interventions. Results Results are presented as odds ratios [95% confidence intervals] and p-values. Girls were significantly more likely to have spinal braces than boys; 1.54 [1.07, 2.22] p < 0.05, a significant interaction with place of birth indicated fewer spinal braces prescribed to children born outside of the Nordic countries; 0.20 [0.079, 0.53] p < 0.001. Girls were less likely to have undergone selective dorsal rhizotomy (SDR); 0.49 [0.25, 0.94] p < 0.05. Individuals born outside of the Nordic countries, were significantly less likely to have received intrathecal baclofen (ITB) 0.27 [0.074, 0.98] p < 0.05. Conclusions Of the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was noted for spinal bracing and having received ITB treatment. Other PT and OT treatments were associated with age, level of spasticity, and functional severity as classified using the GMFCS and the MACS. Increased awareness of differences based on gender, and where a child is born, could be obtained by inter- and intraprofessional discussions.

scholarly journals Oral health in children and adolescents with juvenile idiopathic arthritis – a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marit S. Skeie ◽  
Elisabeth G. Gil ◽  
Lena Cetrelli ◽  
Annika Rosén ◽  
Johannes Fischer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Juvenile Idiopathic Arthritis ◽  
Oral Health ◽  
Children And Adolescents ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Diseases ◽  
Cross Sectional ◽  
Healthy Group ◽  
Health Measures

Abstract Background Observational studies examining the association between oral health and juvenile idiopathic arthritis (JIA) among children and adolescents have reported inconsistent findings. The aims of this systematic review and meta-analysis were to ascertain a potential difference in oral health and oral health-related quality of life (OHRQoL) among children and adolescents with JIA and healthy peers, and to assess the association of prevalence of oral diseases/conditions, temporomandibular disorders (TMD), including temporomandibular joint (TMJ) diseases, in relation to activity and severity of JIA. Method Medline Ovid, Embase, CINAHL, SweMed+ and Cochrane Library were searched up to 25 November 2018. All articles published in English, German and Scandinavian languages focusing on children and adolescents with JIA and without JIA in relation to oral health measures, were considered. Two authors independently evaluated observational studies for inclusion. The study quality was assessed using modified Newcastle Ottawa Scale. Meta-analysis was performed for studies focusing on dental caries as an outcome. Results Nineteen articles met the inclusion criteria, covering a range of oral diseases/conditions and OHRQoL. Eighteen studies had cross-sectional design. No mean difference of dmft/DMFT indices (decayed/missed/filled teeth) was observed between the JIA - and healthy group. None of the oral health measures including dental erosive wear, enamel defects, dental maturation and OHRQoL, indicated better oral health among children and adolescents with JIA compared to healthy group. However, periodontal conditions and TMD were more predominant among children and adolescents with JIA compared to healthy peers. Conclusions Based on the cross-sectional studies, periodontal diseases and TMD were found to be more frequent in children and adolescents with JIA compared to healthy peers. Furthermore, more high-quality studies with large sample size are needed before we infer any concrete conclusion regarding the association between the prevalence of oral and TMJ diseases or oral conditions in relation to activity and severity of JIA.

scholarly journals Assessment of the influence of overweight and obesity on the development of prehypertension and hypertension in children aged 6-15

2021 ◽  
Vol 50 (4) ◽  
pp. 85-96
Author(s):  
Marijana Jandrić-Kočić
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Primary School ◽  
Children And Adolescents ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Primary School Children ◽  
Cross Sectional ◽  
Significant Difference ◽  
Hypertension In Children

Introduction/Aim: 41 million children under the age of 5 and 340 million children and adolescents aged 5 to 19 are overweight or obese. Obesity in children and adolescents is the most important predictor of high blood pressure. The aim of the study was to examine the incidence of overweight and obesity in primary school children aged 6 to 15 years, as well as to examine the incidence of prehypertension and hypertension in children who were overweight and obese. Method: The study included 85 of 86 children from the Primary School "Krupa na Uni". Data were collected with the help of a questionnaire, while body weight and blood pressure were measured. The chi-square test and t-test were used for the statistical analysis of data Results: The cross-sectional study included 85 children, 45 (52.9%) boys and 40 (47.1%) girls with an average age of 10.87 ± 2.70 years. Normal weight was found in 54 (63.5%) subjects, underweight in 12 (14.1%), overweight in 5 (5.9%), and obesity in 14 (16.5%). 76 (89.4%) subjects had normal blood pressure values, 5 (5.9%) prehypertensive state, and 4 (4.7%) arterial hypertension. There was no significant difference between younger and older children regarding their nutritional status (p=0.477) and blood pressure levels (p=0.453). Children who were overweight and obese had prehypertension and hypertension significantly more often (p˂0.001). Conclusion: Every fifth child was overweight or obese, while prehypertension or hypertension were found in every tenth child. The timely change of diet and physical activity could contribute to the regulation of body weight and the regulation of blood pressure, as well.

scholarly journals Three-dimensional volumetric evaluation of the different mandibular segments using CBCT in patients affected by juvenile idiopathic arthritis: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Davide Cavagnetto ◽  
Andrea Abate ◽  
Alberto Caprioglio ◽  
Paolo Cressoni ◽  
Cinzia Maspero
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Three Dimensional ◽  
Pairwise Comparison ◽  
Cross Sectional Study ◽  
Control Group ◽  
Case Group ◽  
Unaffected Side ◽  
Cross Sectional ◽  
Affected Side ◽  
Significant Difference

Abstract Background There is currently no information on how different mandibular segments are affected by juvenile idiopathic arthritis. The aim of this paper is to assess volumetric differences of different mandibular segments in subjects with unilateral and bilateral JIA and to compare them with non-JIA control volumes. Materials and methods Forty subjects with unilateral TMJ involvement and 48 with bilateral TMJ involvement were selected for the case group and 45 subjects with no known rheumatic comorbidities for the control group. The mandible of each subject was divided according to a validated method into different paired volumes (hemimandible, condyle, ramus and hemibody). Results The ANOVA test revealed a statistically significant difference in all the groups for condylar and ramus volumes, and the pairwise comparison evidenced a statistically significant higher condylar and ramus volume in the control group (1444.47 mm3; 5715.44 mm3) than in the affected side in the unilateral JIA group (929.46 mm3; 4776.31 mm3) and the bilateral JIA group (1068.54 mm3; 5715.44 mm3). Moreover, there was also a higher condylar volume in the unaffected side in the unilateral JIA group (1419.39 mm3; 5566.24 mm3) than in the bilateral JIA group and the affected side in the unilateral JIA group. Conclusions The affected side of unilateral JIA patients showed statistically significant lower volumes in the hemimandible, in the condyle and in the ramus. The largest total mandibular volume was observed in the control group, followed by the unilateral JIA group and, lastly, by the bilateral JIA group.

scholarly journals The Increased Levels of Fecal Calprotectin in Children With Active Enthesitis Related Arthritis and MRI Signs of Sacroiliitis: The Results of a Single Center Cross-Sectional Exploratory Study in Juvenile Idiopathic Arthritis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Lovro Lamot ◽  
Marijana Miler ◽  
Rudolf Vukojević ◽  
Mandica Vidović ◽  
Mirta Lamot ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Exploratory Study ◽  
Clinical Laboratory ◽  
Surrogate Marker ◽  
Fecal Calprotectin ◽  
Musculoskeletal Symptoms ◽  
Cross Sectional ◽  
Enthesitis Related Arthritis ◽  
Significant Difference ◽  
Juvenile Spondyloarthritis

Enthesitis related arthritis (ERA) is a specific subtype of juvenile idiopathic arthritis (JIA), often regarded as an undifferentiated form of juvenile spondyloarthritis (jSpA). While gut is increasingly recognized as origin and/or target of inflammation in adult onset spondyloarthritis (SpA), the incidence of gut involvement in ERA patients is largely unknown. The aim of this study was to measure the concentration of fecal calprotectin (fCAL), a surrogate marker of gut inflammation, in patients with different subtypes of JIA, as well as to correlate the results with various demographic, clinical, laboratory, imaging, and treatment characteristics. The cross-sectional exploratory study involving 71 patients with ERA, other forms of JIA and children complaining musculoskeletal symptoms was therefore conducted. Along with fCAL assessment, a detailed clinical and laboratory examination was performed, including the calculation of a composite disease activity scores. Moreover, MRI of the sacroiliac joints was performed in all ERA and other patients complaining of low back pain. The median concentration of fCAL was highest in ERA patients (33.2 mg/kg, p = 0.02), with a significant difference between those with inactive and active disease (20.0 vs. 57.4, p = 0.01), as well as those with and without MRI signs of sacroiliitis (22.6 vs. 54.3, p = 0.04). The fCAL did not differ depending on the NSAID use (23 vs. 20, p = 0.18), although weak correlation was observed with the treatment duration (r = 0.25, p = 0.03). In conclusion, our findings indicate that a parallel inflammation in musculoskeletal system and gut can occur not just in adults with SpA, but in children with ERA as well.

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