Temporomandibular Joint Involvement in Children with Juvenile Idiopathic Arthritis

2010 ◽  
Vol 38 (3) ◽  
pp. 510-515 ◽  
Author(s):  
ELVIRA CANNIZZARO ◽  
SILKE SCHROEDER ◽  
LUKAS M. MÜLLER ◽  
CHRISTIAN J. KELLENBERGER ◽  
ROTRAUD K. SAURENMANN
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Temporomandibular Joint ◽  
Upper Extremity ◽  
Age At Onset ◽  
Disease Onset ◽  
Joint Involvement ◽  
Hla B27 ◽  
Radiological Findings ◽  
Rheumatology Clinic ◽  
Younger Age

Objective.To determine the rate of temporomandibular joint (TMJ) involvement and find factors associated with TMJ arthritis in a single-center cohort of patients with juvenile idiopathic arthritis (JIA).Methods.Retrospective analysis of all patients with JIA visiting the rheumatology clinic between January 1, 2005, and December 31, 2006. Followup information was included until August 2008. A diagnosis of TMJ arthritis was based on clinical rheumatological and/or radiological findings.Results.After a mean followup time for JIA of 4.6 years (range 0.08–14.17), 86/223 patients (38.6%) had developed TMJ arthritis. The rate of TMJ involvement differed significantly among JIA subtypes (p = 0.0016), with 61% in extended oligoarticular, 52% in polyarticular rheumatoid factor (RF)-negative, 50% in psoriatic, 36% in systemic, 33% in polyarticular RF-positive, 33% in persistent oligoarticular, 30% in unclassified JIA, and 11% in enthesitis-related arthritis. The rate of TMJ involvement in our cohort was statistically significantly lower for patients who were HLA-B27-positive (p = 0.0002). In a multivariate analysis, the association of the following factors was confirmed: JIA subtype (p = 0.0001), a higher erythrocyte sedimentation rate (ESR) at diagnosis (p = 0.0038), involvement of joints of the upper extremity (p = 0.011), the absence of HLA-B27 (p = 0.023), and younger age at onset of JIA (p = 0.050).Conclusion.In our cohort of children with JIA, the overall rate of TMJ involvement was 38.6%. Patients with certain JIA subtypes, a higher ESR at disease onset, involvement of upper extremity joints, and younger age at diagnosis were more likely to develop TMJ arthritis. The presence of HLA-B27 seemed to be protective.

HLA-B27 Predicts a More Chronic Disease Course in an 8-year Followup Cohort of Patients with Juvenile Idiopathic Arthritis

2013 ◽  
Vol 40 (5) ◽  
pp. 725-731 ◽  
Author(s):  
Lillemor Berntson ◽  
Ellen Nordal ◽  
Kristiina Aalto ◽  
Suvi Peltoniemi ◽  
Troels Herlin ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Population Based ◽  
Hla B27 ◽  
Disease Characteristics ◽  
Serological Data ◽  
Longterm Outcome

Objective.We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA).Methods.We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible.Results.HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease.Conclusion.In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease.

scholarly journals Younger age of onset and uveitis associated with HLA-B27 and delayed diagnosis in Thai patients with axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naphruet Limsakul ◽  
Praveena Chiowchanwisawakit ◽  
Parichart Permpikul ◽  
Yubolrat Thanaketpaisarn
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Delayed Diagnosis ◽  
Musculoskeletal Symptom ◽  
Hla B27 ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Younger Age

AbstractTo identify characteristics associated with HLA-B27, and to identify factors associated with delayed diagnosis in Thai patients with axial spondyloarthritis (axSpA). This cross-sectional study included Thai patients were diagnosed with axSpA by a rheumatologist at Siriraj Hospital. Clinical data were collected. Regression analyses were employed to identify factors associated with study outcomes. Of total 177 patients, 127 (72%) were positive HLA-B27. Uveitis [Odds ratio (OR) 4.0], age at onset of the first musculoskeletal symptom of ≤ 28 years [OR 3.5], female [OR 0.4], and psoriasis [OR 0.4] were significantly associated with HLA-B27 in multiple regression analysis. Those with positive HLA-B27 had less spinal flexibility. Elevated C-reactive protein (p = 0.012) was associated with shorter delay in diagnosis, while uveitis (p < 0.001) and younger age at onset of the first symptom (p = 0.002) were associated with longer delay in diagnosis in multiple regression analysis. Younger age at onset of the first musculoskeletal symptom and uveitis were associated with HLA-B27 and delayed diagnosis in axSpA patients. Young people with musculoskeletal symptom and uveitis should be referred to a rheumatologist to rule out or make a timely diagnosis of axSpA.

scholarly journals Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Willemijn F. C. de Sonnaville ◽  
Caroline M. Speksnijder ◽  
Nicolaas P. A. Zuithoff ◽  
Daan R. C. Verkouteren ◽  
Nico W. Wulffraat ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Healthy Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Explanatory Factors ◽  
Left And Right

Abstract Background Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. Methods This cross-sectional study included children with JIA and healthy children of age 6–18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. Results A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. Conclusion All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.

Craniofacial Growth in Children Affected by Juvenile Idiopathic Arthritis Involving the Temporomandibular Joint: Functional Therapy Management

2009 ◽  
Vol 33 (4) ◽  
pp. 351-357 ◽  
Author(s):  
Giampietro Farronato ◽  
Vera Carletti ◽  
Cinzia Maspero ◽  
Davide Farronato ◽  
Lucia Giannini ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Temporomandibular Joint ◽  
Joint Involvement ◽  
Craniofacial Growth ◽  
Mandibular Ramus ◽  
Functional Appliance ◽  
Functional Therapy ◽  
Gonial Angle ◽  
Mandibular Retrusion ◽  
Posterior Height

The aim of this study was twofold: 1) to asses the effects of a functional appliance on condyles damaged by juvenile idiopathic arthritis (JIA). and 2) to evaluate its ability to reduce alterations in craniofacial development.Study design: Seventy-two JIA patients with temporomandibular involvement, ages ranging between 4 and 16 years, were treated. All of them presented temporomandibular joint involvement. They were treated with an activator and followed for 4 years. Results: At the second examination, it was possible to observe a reduction in mandibular retrusion and in the sagittal discrepancy between mandible and maxilla, a reduction in the angle of divergence, a counterclockwise rotation of the mandible, a reduction of the gonial angle, a longer mandibular ramus, a reduction in the discrepancy between anterior and posterior height caused by an increase in posterior height and a forward positioning of the chin. Conclusion: The functional appliance reduces the severity of facial alterations improving mandibular and condylar growth.

scholarly journals Oral health and temporomandibular joint involvement of patient with juvenile idiopathic arthritis

2018 ◽  
Vol 14 (3) ◽  
pp. 73-79
Author(s):  
Figen Eren Giray ◽  
Başak Durmuş ◽  
Ferhan Ertuğral ◽  
Müferet Ergüven ◽  
İlknur Tanboğa
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Oral Health ◽  
Temporomandibular Joint ◽  
Joint Involvement
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