Incidence of temporomandibular involvement in juvenile idiopathic arthritis

Abstract

Objective: Temporomandibular joint (TMJ) involvement is a frequent feature in cross‐sectional prevalence studies among juvenile idiopathic arthritis (JIA) patients. The cross‐sectional design makes it almost impossible to study the incidence. Follow‐up data on TMJ involvement are sparse. In this study patients were reviewed with an interval of a minimum of 1 year and a maximum of 2 years to study the yearly incidence of TMJ involvement and to obtain follow‐up data on TMJ involvement and orthopantomogram (OPT) alterations.

Methods: Children with JIA from a previous study on TMJ involvement were included. OPTs were scored according to Rohlin's grading system (grade 0–5). A paediatric rheumatologist measured the level of disease activity during the interval.

Results: Eighty‐nine of the 97 patients were included in this study with a mean follow‐up of 14 months. The yearly incidence of TMJ involvement was 7.1% in patients with JIA. Improvement on the OPT was seen in 27 patients (66%), and 19 of these patients no longer showed any signs of TMJ involvement. Worsening on the OPT was seen in four patients (10%). Disease activity was significantly lower in the improved patients than in the patients with worsening.

Conclusion: Condylar lesions due to arthritis can improve over time, indicating a regenerative capacity of the mandibular condyle. As condylar improvement seems to be associated with low disease activity, it is important to consider the TMJ when deciding on a therapeutic regimen.