A Retrospective Study on Possible Predictive Factors for Long-term Temporomandibular Joint Degeneration and Impaired Mobility in Juvenile Arthritis Patients.

Abstract

To determine possible predictive factors for long-term temporomandibular joint (TMJ) degeneration and dysfunction in juvenile idiopathic arthritis (JIA) patients. A total of 94 patients (77% female) who had received a JIA diagnosis in an outpatient rheumatology clinic from 1993 to 1994 at a mean ± standard deviation age of 8.3 ± 4.53 years were included in the study. At inclusion, TMJ status regarding condylar degeneration was assessed orthopantomographically and given a Rohlin and Petersson score of 0 or ≥ 1. The maximal mouth opening (MMO) was also measured. Data on possible predictors were gathered retrospectively from the consultation at intake: gender, age at JIA onset, JIA subtype, physical limitations (ie, a Steinbrocker classification score of 0 or ≥ 1), human leukocyte antigen-B27, and antinuclear and rheumatoid factors. Disease duration and medication type were also considered. Associations between all of these factors and long-term condylar degeneration and MMO were assessed by using single and multiple regression analyses. Long-term TMJ degeneration and smaller MMO were both associated with younger age at JIA onset (P = .01; P = .03) and longer disease duration (P = .05; P = .002). Moreover, MMO was negatively associated with physical limitations at intake (P = .04). Within the limitations of this retrospective study design, these results suggest that young JIA patients with early physical limitations and prolonged disease are at risk of long-term TMJ degeneration and impaired mobility.