Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis

Mia Glerup; Peter Bangsgaard Stoustrup; Louise Hauge Matzen; Veronika Rypdal; Ellen Nordal; Paula Frid; Ellen Dalen Arnstad; Marite Rygg; Olafur Thorarensen; Maria Ekelund; Lillemor Berntson; Anders Fasth; Håkan Nilsson; Suvi Peltoniemi; Kristiina Aalto; Sirpa Arte; Peter Toftedal; Susan Nielsen; Sven Kreiborg; Troels Herlin; Thomas Klit Pedersen

doi:10.3899/jrheum.190231

Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis

Mia Glerup, Peter Bangsgaard Stoustrup, Louise Hauge Matzen, Veronika Rypdal, Ellen Nordal, Paula Frid, Ellen Dalen Arnstad, Marite Rygg, Olafur Thorarensen, Maria Ekelund, Lillemor Berntson, Anders Fasth, Håkan Nilsson, Suvi Peltoniemi, Kristiina Aalto, Sirpa Arte, Peter Toftedal, Susan Nielsen, Sven Kreiborg, Troels HerlinThomas Klit Pedersen

Section 02 - Paediatric Dentistry

6 Citations (Scopus)

Abstract

OBJECTIVE: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.

METHODS: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.

RESULTS: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the JIA. The mean maximal incisal opening was lower in the JIA group (p<0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.

CONCLUSION: This first study on long-term consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary follow-up of JIA patients also in adulthood.

Original language	English
Journal	Journal of Rheumatology
Number of pages	22
ISSN	0315-162X
DOIs	https://doi.org/10.3899/jrheum.190231
Publication status	E-pub ahead of print - 15 Sept 2019

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10.3899/jrheum.190231

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Glerup, M., Stoustrup, P. B., Matzen, L. H., Rypdal, V., Nordal, E., Frid, P., Arnstad, E. D., Rygg, M., Thorarensen, O., Ekelund, M., Berntson, L., Fasth, A., Nilsson, H., Peltoniemi, S., Aalto, K., Arte, S., Toftedal, P., Nielsen, S., Kreiborg, S., ... Pedersen, T. K. (2019). Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis. Journal of Rheumatology. Advance online publication. https://doi.org/10.3899/jrheum.190231

Glerup, M, Stoustrup, PB, Matzen, LH, Rypdal, V, Nordal, E, Frid, P, Arnstad, ED, Rygg, M, Thorarensen, O, Ekelund, M, Berntson, L, Fasth, A, Nilsson, H, Peltoniemi, S, Aalto, K, Arte, S, Toftedal, P, Nielsen, S, Kreiborg, S, Herlin, T & Pedersen, TK 2019, 'Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis', Journal of Rheumatology. https://doi.org/10.3899/jrheum.190231

@article{af77338f96664d5d9c824b61b667bae4,

title = "Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis",

abstract = "OBJECTIVE: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.METHODS: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.RESULTS: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the JIA. The mean maximal incisal opening was lower in the JIA group (p<0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.CONCLUSION: This first study on long-term consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary follow-up of JIA patients also in adulthood.",

author = "Mia Glerup and Stoustrup, {Peter Bangsgaard} and Matzen, {Louise Hauge} and Veronika Rypdal and Ellen Nordal and Paula Frid and Arnstad, {Ellen Dalen} and Marite Rygg and Olafur Thorarensen and Maria Ekelund and Lillemor Berntson and Anders Fasth and H{\aa}kan Nilsson and Suvi Peltoniemi and Kristiina Aalto and Sirpa Arte and Peter Toftedal and Susan Nielsen and Sven Kreiborg and Troels Herlin and Pedersen, {Thomas Klit}",

year = "2019",

month = sep,

day = "15",

doi = "10.3899/jrheum.190231",

language = "English",

journal = "Journal of Rheumatology",

issn = "0315-162X",

publisher = "Journal of Rheumatology Publishing Co. Ltd.",

}

TY - JOUR

T1 - Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis

AU - Glerup, Mia

AU - Stoustrup, Peter Bangsgaard

AU - Matzen, Louise Hauge

AU - Rypdal, Veronika

AU - Nordal, Ellen

AU - Frid, Paula

AU - Arnstad, Ellen Dalen

AU - Rygg, Marite

AU - Thorarensen, Olafur

AU - Ekelund, Maria

AU - Berntson, Lillemor

AU - Fasth, Anders

AU - Nilsson, Håkan

AU - Peltoniemi, Suvi

AU - Aalto, Kristiina

AU - Arte, Sirpa

AU - Toftedal, Peter

AU - Nielsen, Susan

AU - Kreiborg, Sven

AU - Herlin, Troels

AU - Pedersen, Thomas Klit

PY - 2019/9/15

Y1 - 2019/9/15

N2 - OBJECTIVE: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.METHODS: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.RESULTS: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the JIA. The mean maximal incisal opening was lower in the JIA group (p<0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.CONCLUSION: This first study on long-term consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary follow-up of JIA patients also in adulthood.

AB - OBJECTIVE: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.METHODS: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997-2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The follow-up visit included demographic data, a standardized clinical orofacial examination, and fullface cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.RESULTS: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 years) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least one orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Furthermore, among participants reporting complaints, the number of symptoms was also higher in the JIA. The mean maximal incisal opening was lower in the JIA group (p<0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.CONCLUSION: This first study on long-term consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary follow-up of JIA patients also in adulthood.

U2 - 10.3899/jrheum.190231

DO - 10.3899/jrheum.190231

M3 - Journal article

C2 - 31523047

SN - 0315-162X

JO - Journal of Rheumatology

JF - Journal of Rheumatology

ER -

Long-term Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis

Abstract

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