Department of Paediatric Dentistry, Blekinge Hospital, Karlskrona, Sweden.
Scand J Rheumatol. 2012 Oct;41(5):375-8. doi: 10.3109/03009742.2012.675585. Epub 2012 May 28.
Juvenile idiopathic arthritis (JIA) frequently causes temporomandibular joint (TMJ) inflammation. The aim of this study was to evaluate the presence of orofacial pain and temporomandibular dysfunction in patients with JIA and controls. METHODS. Forty-one patients with JIA and 41 age- and sex-matched healthy controls participated. Subjects were asked about facial pain variables and their influence on daily life. A clinical examination was performed. Panoramic radiograph and medical data were extracted from the records.
Thirty-three of the JIA patients reported TMJ or facial pain compared to four of the controls (p < 0.001). Nine of the JIA patients, compared to none of the controls, reported that their orofacial symptoms influenced daily life severely (p < 0.001). Clinical findings were more prevalent in JIA (p < 0.001). The assessments of disease activity correlated to palpation pain of jaw muscles (p < 0.001) whereas the presence of structural TMJ changes correlated to reduced jaw opening (p < 0.001).
TMJ pain was prevalent in patients with JIA and influenced daily life severely for nearly a quarter of them. Collaboration between medical and dental care is therefore important.
幼年特发性关节炎（JIA）常引起颞下颌关节（TMJ）炎症。本研究旨在评估 JIA 患者和对照组患者是否存在口腔颌面部疼痛和颞下颌关节功能障碍。
纳入 41 例 JIA 患者和 41 名年龄和性别匹配的健康对照者。询问受试者关于面部疼痛变量及其对日常生活的影响。进行临床检查。从病历中提取全景片和医学数据。
33 例 JIA 患者报告 TMJ 或面部疼痛，而对照组仅 4 例（p < 0.001）。9 例 JIA 患者报告其口腔颌面部症状严重影响日常生活，而对照组无此报告（p < 0.001）。JIA 患者的临床发现更为普遍（p < 0.001）。疾病活动度评估与颌骨肌肉触诊疼痛相关（p < 0.001），而 TMJ 结构改变的存在与张口受限相关（p < 0.001）。
JIA 患者中 TMJ 疼痛较为普遍，近四分之一的患者疼痛严重影响日常生活。因此，医疗和牙科护理的协作非常重要。
