Analysis of Earlier Temporomandibular Joint Disorders in JIA Patients: A Clinical Report.

Alessandro Polizzi,Giuseppe Marzo,Gaetano Isola,Simona Santonocito,Vincenzo Quinzi,Giuseppe Palazzo

doi:10.3390/healthcare9091140

Alessandro Polizzi, Giuseppe Marzo + Show 4 more

Open Access

https://doi.org/10.3390/healthcare9091140

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Journal: Healthcare	Publication Date: Aug 31, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: University of Catania, University of L'Aquila

Abstract

The aim of this study was to analyse the structural characteristics of the temporo-mandibular joint (TMJ) and the dysfunctional consequences induced by disease in subjects with juvenile idiopathic arthritis (JIA). The study was conducted in 25 patients with JIA (median age (IQR), 13.9 (10.9–15.3)) and 26 healthy controls (median age (IQR), 14.3 (11.6–17.2)) years. All enrolled patients were subjected to anamnestic evaluation, laboratory parameters, JIA subclass, and type of therapy for the disease. A clinical-gnathological evaluation, anamnestic and dysfunctional index (Ai and Di), and magnetic resonance imaging of TMJs were performed in all patients. The test group showed a significant reduction (p < 0.001) regarding the clinical findings such as maximal mouth opening, left and rightward laterotrusion and protrusion, and a significant difference in the reported symptoms (TMJ sounds, reduced mouth opening and pain), and Ai and Di (p < 0.001) compared to healthy patients. Correlation analysis showed a significant correlation between the median duration of disease and the maximum mouth opening and between visual analogue scale (VAS) score and maximum mouth opening, leftward laterotrusion, rightward laterotrusion, and protrusion. The results obtained in this study suggest that patients with JIA presented a cohort of symptoms in TMJs in comparison with healthy controls. Moreover, a careful TMJs evaluation and an early diagnosis of TMJs dysfunction and regular follow-ups are recommended in order to prevent and reduce functional and chewing problems in patients with JIA.

Highlights

Juvenile idiopathic arthritis (JIA) includes all chronic forms of arthritis that occur before the age of 16, which lasts over six weeks and cannot be traced back to a known cause [1].Among the chronic inflammatory diseases of paediatric age, it is the most frequent; its incidence and prevalence range from 2 to 20 per 100,000 children [2]
The present study demonstrated that JIA patients presented a higher prevalence and severity of temporo-mandibular joint (TMJ) symptoms and signs of dysfunction compared to the control group
The results of this study evidenced that TMJ involvement is more frequent and severe in JIA patients compared to healthy subjects, especially in female patients with JIA in polyarticular form

Summary

Introduction

Juvenile idiopathic arthritis (JIA) includes all chronic forms of arthritis that occur before the age of 16, which lasts over six weeks and cannot be traced back to a known cause [1]. Among the chronic inflammatory diseases of paediatric age, it is the most frequent; its incidence and prevalence range from 2 to 20 per 100,000 children [2]. There are some critical observations in consideration of the pathogenesis and aetiology of JIA. JIA is a chronic disease characterised by T-cell abnormalities, and the pathological features of chronic synovitis suggest possible cell-mediated pathogenesis [4]. The JIA may appear as a consequence of an oligogenic or polygenic predisposition. The various forms of the disease show non-mendelian inheritance, a resulting consequence of interactions of multiple genes [5]

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