Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
Section of Orthodontics, Aarhus University, Aarhus, Denmark.
Arthritis Rheumatol. 2023 Sep;75(9):1658-1667. doi: 10.1002/art.42481. Epub 2023 Jun 6.
To estimate the cumulative incidences of orofacial conditions related to temporomandibular joint (TMJ) juvenile idiopathic arthritis (JIA) between diagnosis in childhood to transition into adult care, and to identify features in JIA associated with TMJ involvement.
A population-based cohort analysis was conducted of patients with JIA involving longitudinal data on orofacial health from 2000 to 2018. Regardless of TMJ status, the patients were referred to the Regional Specialist Craniofacial Clinic of Western Denmark for routine orofacial examinations. Data collection included information about disease-specific background characteristics, TMJ involvement, JIA-induced dentofacial deformity, and orofacial symptoms and dysfunction.
A total of 613 patients were followed up with a mean clinical TMJ observation time of 4.0 years. From JIA onset to transition into adult care, the cumulative incidence of patients with JIA involvement of the TMJ was 30.1%. Furthermore, 20.6% of the cohort had developed arthritis-induced dentofacial deformity. A substantial proportion of the cohort experienced several events with orofacial symptoms (23.5%) and dentofacial dysfunction (52%). Young age at diagnosis (<9 years), female gender, and antinuclear antibody positivity were significantly associated with TMJ involvement.
Orofacial signs and symptoms were frequent findings in children and adolescents with JIA. TMJ involvement was seen in 30.1% of the cohort; and 20.6% of the total cohort developed JIA-related dentofacial deformity before transition into adult care. This is the first population-based study in the era of available biologic treatments to document these frequent orofacial complications in children with JIA.
估计儿童期诊断至过渡至成人期的青少年特发性关节炎（JIA）患者发生与颞下颌关节（TMJ）相关的口腔状况的累积发生率，并确定与 TMJ 受累相关的 JIA 特征。
对涉及 2000 年至 2018 年纵向口腔健康数据的 JIA 患者进行基于人群的队列分析。无论 TMJ 状态如何，患者均被转诊至丹麦西部区域颅面专家诊所进行常规口腔检查。数据收集包括疾病特异性背景特征、TMJ 受累、JIA 引起的牙颌面畸形以及口腔症状和功能障碍的信息。
共有 613 例患者接受了随访，TMJ 临床观察时间的平均为 4.0 年。从 JIA 发病到过渡至成人期，TMJ 受累的 JIA 患者累积发生率为 30.1%。此外，该队列中有 20.6%的患者出现了关节炎引起的牙颌面畸形。相当一部分患者经历了口腔症状（23.5%）和牙颌面功能障碍（52%）。诊断时年龄较小（<9 岁）、女性和抗核抗体阳性与 TMJ 受累显著相关。
在患有 JIA 的儿童和青少年中，口腔表现和症状较为常见。TMJ 受累在队列中占 30.1%；在过渡至成人期之前，总队列中有 20.6%的患者出现了与 JIA 相关的牙颌面畸形。这是在有生物治疗可用的时代，首次针对儿童 JIA 患者的这些常见口腔并发症进行的基于人群的研究。
