J Oral Facial Pain Headache. 2017;31(2):165-171. doi: 10.11607/ofph.1656.
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.
确定幼年特发性关节炎(JIA)患者长期颞下颌关节(TMJ)退变和功能障碍的可能预测因素。
本研究共纳入 94 例(77%为女性)患者,他们于 1993 年至 1994 年在一家门诊风湿病诊所被诊断为 JIA,平均年龄为 8.3 ± 4.53 岁。纳入时,通过全景片评估 TMJ 髁突退变情况,并给予 Rohlin 和 Petersson 评分 0 或≥1。还测量了最大张口度(MMO)。从纳入时的就诊中回顾性收集可能的预测因素数据:性别、JIA 发病年龄、JIA 亚型、身体受限(即 Steinbrocker 分类评分 0 或≥1)、人类白细胞抗原-B27 以及抗核和类风湿因子。还考虑了疾病持续时间和药物类型。使用单因素和多因素回归分析评估所有这些因素与长期髁突退变和 MMO 的关系。
长期 TMJ 退变和较小的 MMO 均与 JIA 发病年龄较小(P =.01;P =.03)和疾病持续时间较长(P =.05;P =.002)相关。此外,MMO 与纳入时的身体受限呈负相关(P =.04)。
在本回顾性研究设计的限制内,这些结果表明,早期存在身体受限和疾病持续时间较长的年轻 JIA 患者有发生长期 TMJ 退变和活动受限的风险。