Polizzi Alessandro, Quinzi Vincenzo, Santonocito Simona, Palazzo Giuseppe, Marzo Giuseppe, Isola Gaetano
Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy.
Department of Life Health and Environmental Sciences, University of L'Aquila, 61700 L'Aquila, Italy.
Healthcare (Basel). 2021 Aug 31;9(9):1140. doi: 10.3390/healthcare9091140.
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 ( < 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 ( < 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.
本研究的目的是分析青少年特发性关节炎(JIA)患者颞下颌关节(TMJ)的结构特征以及疾病引起的功能障碍后果。该研究纳入了25例JIA患者(年龄中位数(四分位间距),13.9(10.9 - 15.3)岁)和26名健康对照者(年龄中位数(四分位间距),14.3(11.6 - 17.2)岁)。所有纳入的患者均接受了问诊评估、实验室参数检查、JIA亚类及疾病治疗类型的评估。对所有患者进行了临床口腔颌面评估、问诊及功能障碍指数(Ai和Di)评估以及TMJ的磁共振成像检查。与健康患者相比,试验组在最大开口度、左右侧方运动及前伸运动等临床检查结果方面显著降低(<0.001),在报告的症状(TMJ弹响、开口受限及疼痛)以及Ai和Di方面也存在显著差异(<0.001)。相关性分析显示疾病的中位病程与最大开口度之间以及视觉模拟评分(VAS)与最大开口度、左侧方运动、右侧方运动和前伸运动之间存在显著相关性。本研究获得的结果表明,与健康对照者相比,JIA患者的TMJ存在一系列症状。此外,建议对TMJ进行仔细评估,早期诊断TMJ功能障碍并定期随访,以预防和减少JIA患者的功能及咀嚼问题。