Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland.
Eur J Orthod. 2023 Feb 10;45(1):88-95. doi: 10.1093/ejo/cjac037.
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease in which temporomandibular joint (TMJ) arthritis commonly occurs. It may be asymptomatic and could cause problems in the growing joints. Our aim was to evaluate the craniofacial structures, occlusal features and temporomandibular dysfunction (TMD) symptoms of patients with JIA.
The study consisted of 195 JIA patients treated at the Department of Oral and Maxillofacial Diseases, Helsinki University Hospital (HUH), Finland between 2015 and 2019. We retrospectively screened their medical and dental records and classified them according to age at JIA diagnosis (<7 and ≥7 years).
Most of the patients had Angle Class I occlusion in both sides. Among all the patients, the mean overjet, and overbite were 3.3 mm and 2.4 mm, respectively. There were more open bite patients in the ≥7 years old group than in the <7 years old group (P = 0.010). Of all patients, 47% reported at least one TMD symptom. The TMD symptoms were more common in participants ≥7 years old than those <7 years old (P = 0.005).
Occlusal features and the incidence of malocclusions seem to have similar tendency among the JIA patients with systematic visits in rheumatologist and orthodontist as in the healthy population, except for open bite that is more common with JIA patients. While treating JIA patients, a well-functioning collaboration between paediatric rheumatologists and orthodontists is essential, as well as a clear screening protocol to detect potentially asymptomatic TMJ arthritis. Particular attention should be paid to children with JIA under school age.
幼年特发性关节炎（JIA）是一种慢性炎症性疾病，常累及颞下颌关节（TMJ）关节炎。它可能是无症状的，但会导致生长中的关节出现问题。我们的目的是评估 JIA 患者的颅面结构、咬合特征和颞下颌关节功能紊乱（TMD）症状。
本研究纳入了 2015 年至 2019 年期间在芬兰赫尔辛基大学医院（HUH）口腔颌面疾病科接受治疗的 195 例 JIA 患者。我们回顾性筛选了他们的医疗和牙科记录，并根据 JIA 诊断时的年龄（<7 岁和≥7 岁）进行分类。
大多数患者双侧均为安氏Ⅰ类咬合。所有患者中，平均覆合为 3.3mm，平均覆盖为 2.4mm。≥7 岁组的开颌患者多于<7 岁组（P=0.010）。所有患者中，47%至少报告了一种 TMD 症状。≥7 岁组的 TMD 症状比<7 岁组更常见（P=0.005）。
除开颌外，在接受风湿科医生和正畸医生系统就诊的 JIA 患者中，咬合特征和错颌畸形的发生率与健康人群相似。在治疗 JIA 患者时，儿科风湿科医生和正畸科医生之间需要进行良好的协作，以及制定明确的筛查方案以发现潜在的无症状 TMJ 关节炎。应特别关注学龄以下的 JIA 患儿。
