MD/PhD Student, Emory University School of Medicine and Georgia Institute of Technology, Coulter Department of Biomedical Engineering, Atlanta, GA.
Medical Student, Rocky Vista University, College of Osteopathic Medicine, Research Coordinator at Emory University, Denver, CO.
J Oral Maxillofac Surg. 2022 Sep;80(9):1466-1473. doi: 10.1016/j.joms.2022.05.009. Epub 2022 Jun 7.
Articulation of the temporomandibular joint (TMJ) generates sounds with specific characteristics known as joint acoustic emissions (AEs). The purpose of this project was to determine if AEs as described by the joint health score (JHS) in children with juvenile idiopathic arthritis (JIA) differ from AEs in healthy children.
The investigators implemented a cross-sectional study with age- and sex-matched controls to compare AEs from 4 groups: (1) healthy subjects without TMJ sounds, (2) healthy subjects with TMJ sounds, (3) subjects with JIA without TMJ sounds, and (4) subjects with TMJ sounds. Predictor variables were JIA status (ie JIA/healthy) and joint sounds (present/absent). The outcome variable was AEs. Subjects wore a specialized headset and performed specific jaw movements that generated AEs. AEs were recorded and analyzed using an aggregated decision tree classification model that calculates a JHS for each group. JHSs were compared using a receiver operating characteristic curve and classification accuracies. The study team used a 2-tailed unpaired t-test to determine if score distributions were different. Significance was P < .05.
A total of 51 subjects (102 TMJs; 37 females) with an average age of 13.1 years (range, 7 to 18) participated. Children with JIA and TMJ sounds had AEs with large repetitive clicks. Children with JIA without sounds had smaller repetitive clicks. Healthy children had grinding sounds with lower amplitude. The receiver operating characteristic curve had a classification accuracy of 71.6%. This accuracy compares against the gold standard clinical assessment for placing these patients into their groups (JIA vs healthy). JHSs of children with TMJ sounds and children with JIA and TMJ sounds were statistically significant (P < .0001).
In our sample, the AE of TMJs in healthy children may be different than that in children with JIA. Assessment of an AE is a promising and noninvasive technique to determine involvement of TMJs in children with JIA.
颞下颌关节（TMJ）的关节运动产生具有特定特征的声音，称为关节声发射（AE）。本研究旨在确定儿童特发性关节炎（JIA）患者的 TMJ 声发射（AE）是否与健康儿童的 AE 不同。
研究人员实施了一项具有年龄和性别匹配对照的横断面研究，比较了 4 组的 AE：（1）无 TMJ 声音的健康受试者，（2）有 TMJ 声音的健康受试者，（3）无 TMJ 声音的 JIA 受试者，和（4）有 TMJ 声音的 JIA 受试者。预测变量为 JIA 状态（即 JIA/健康）和关节声音（存在/不存在）。结果变量为 AE。受试者佩戴专用耳机并进行特定的下颌运动，以产生 AE。使用聚合决策树分类模型记录和分析 AE，该模型为每个组计算关节健康评分（JHS）。使用接收者操作特征曲线和分类准确率比较 JHS。研究小组使用双侧非配对 t 检验确定得分分布是否不同。P<.05 表示差异具有统计学意义。
共有 51 名受试者（102 个 TMJ；37 名女性）参与，平均年龄为 13.1 岁（范围为 7 至 18 岁）。有 TMJ 声音和 JIA 的儿童的 AE 具有大的重复咔哒声。无声音的 JIA 儿童的 AE 具有较小的重复咔哒声。健康儿童的 AE 声音为研磨声，幅度较低。接收者操作特征曲线的分类准确率为 71.6%。与将这些患者归入其组别的金标准临床评估相比，这一准确性（JIA 与健康）相当。有 TMJ 声音的儿童和有 TMJ 声音和 JIA 的儿童的 JHS 具有统计学意义（P<.0001）。
在我们的样本中，健康儿童 TMJ 的 AE 可能与 JIA 儿童的 AE 不同。AE 的评估是一种有前途的非侵入性技术，可用于确定 JIA 儿童 TMJ 的受累情况。
