Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: A systematic literature review

Kristensen, Kasper Dahl; Stoustrup, Peter; Küseler, Annelise; Pedersen, Thomas Klit; Twilt, Marika; Herlin, Troels

doi:10.1016/j.semarthrit.2015.11.006

Cited by 58 publications

(65 citation statements)

References 43 publications

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“…Moreover, we found that reduced mouth opening had a predictive value for TMJ damage with an OR of 3.91, which must be regarded as a high risk. The association between reduced mouth opening and TMJ damage has been found in previous studies, suggesting that reduced mouth opening is an important factor to be include in the clinical examination for assessment and to follow‐up of these patients. Assessment of mouth opening capacity over time may in the future be of value to find early TMJ damage.…”

Section: Discussionmentioning

confidence: 57%

“…Finally, in a recent systematic review, the authors evaluated as clinical parameters for the diagnosis of TMJ arthritis in JIA patients subjective pain, TMJ sounds, maximal incisal opening, myofacial pain on palpation and facial asymmetry. They concluded that the low level of evidence does not allow selecting clinically relevant outcome measurements …”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the low level of evidence does not allow selecting clinically relevant outcome measurements. 39 Based on the diagnostic performance of the analysed parameters and the regression analysis, we proposed to associate clinical findings related to pain and to function. In particular, "pain"…”

Section: Discussionmentioning

confidence: 99%

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Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Rongo

Alstergren

Ammendola

et al. 2019

J of Oral Rehabilitation

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Summary Background Diagnostic criteria reported in the expanded taxonomy for temporomandibular disorders include a standardised clinical examination and diagnosis (DC/TMD 3.B) of temporomandibular joint (TMJ) damage in patients with juvenile idiopathic arthritis (JIA); however, their validity is unknown. Objectives To assess the validity of DC/TMD 3.B for the identification of TMJ damage in JIA‐patients, using magnetic resonance imaging (MRI) as gold standard, and to investigate the relation between clinical findings and TMJ damage. Methods Fifty consecutive JIA patients (9‐16 years) were recruited. DC/TMD 3.B were compared with TMJs MRI (100 TMJs) performed maximum at 1 month from the visit. The severity of TMJ damage was scored in four grades. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), logistic regression models with odds ratio of DC/TMD 3.B and clinical findings respect to MRI were calculated. Results The DC/TMD 3.B were inadequate in the identification of TMJ damage (sensitivity = 0.15, specificity = 0.92, PPV = 0.85, NPV = 0.28, P = 0.350). Chin deviation and TMJ crepitus were associated with worse TMJ damage (P = 0.006; P = 0.034). Reduced mouth opening (OR = 3.91, P = 0.039) and chin deviation (OR = 13.7, P = 0.014) were associated with the presence of TMJ damage. Combining “pain” (history of pain, TMJ pain, pain during movements) and “function” (TMJ crepitus, reduced mouth opening, chin deviation) clinical findings, the sensitivity and the specificity were 0.88 and 0.54. Conclusion DC/TMD 3.B present a low sensitivity to diagnose TMJ damage. Chin deviation, reduced mouth opening and TMJ crepitus are associated with TMJ damage. We suggest combining “pain” and “function” findings for the evaluation of TMJ damage in JIA patients.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Rongo

Alstergren

Ammendola

et al. 2019

J of Oral Rehabilitation

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“…In adherence to the institutional protocol [16] and in accordance with the evidence-base [8], MRI evaluation of the TMJ was conducted on contrast-enhanced sequences performed at 1.5 Tesla (Discovery MR450, GE Medical Systems, Milwaukee, USA) with a TMJ surface coil in closed mouth position, performed at the local University Children's hospital. A systematic evaluation of the TMJ affection was performed by an experienced board certified paediatric radiologist (three levels: TMJ not affected, inflammatory activity without osseous destruction, inflammatory activity with osseous destruction), for each joint independently, based on the criteria of established progressive scoring systems both for the level of inflammation and the degree of osteochondral deformation [17][18][19].…”

Section: Mri Evaluation Of the Tmjmentioning

confidence: 99%

“…While several diagnostic approaches, such as ultrasound examination or the evaluation of panoramic films and cephalograms, have been suggested and ultimately questioned [7] in the past, contrast-enhanced magnetic resonance imaging (MRI) remains undisputedly the ideal diagnostic tool for the assessment of inflammatory activity and osteochondral degradation of the TMJ [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of facial asymmetry based on three-dimensional photography: a valuable indicator for asymmetrical temporomandibular joint affection in juvenile idiopathic arthritis patients?

et al. 2020

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Background: Juvenile idiopathic arthritis (JIA) can cause osseous deformity in the temporomandibular joint (TMJ) and may impair mandibular growth. This study aimed to evaluate whether facial asymmetry determined clinically or by morphometric analysis of three-dimensional (3D) photographs in JIA patients is associated with an asymmetric affection of theTMJ.Methods: Of 76 consecutive JIA patients with a mean age of 11.7 years (range: 6.3-17.9), facial asymmetry was evaluated clinically (chin asymmetry, gonion asymmetry), and stereophotogrammetrically with 3D photographs. The facial surfaces were demarcated, then mirrored, superimposed using semi-automated landmarks, and quantitatively assessed (chin asymmetry, Hausdorff distances). Clinical and digital measurements were related to the diagnosis of right and left TMJ involvement derived from magnetic resonance images (MRI). Results: Twenty-seven (34%) patients had an asymmetrical osseous deformity of the TMJ. By clinical evaluation, chin asymmetry was related to asymmetrical osseous destruction (p = 0.02), but gonion asymmetry was not (p = 0.14). In regard to 3D-photograph based morphometric measurements, chin asymmetry was also related to asymmetrical osseous destruction (p = 0.01), but neither the mean (p = 0.06) nor the maximal Hausdorff distance (p = 0.67). Despite the attested significance, none of the chin asymmetry evaluation methods appeared to hold sufficient predictive value (positive predictive values ≤54%; coefficient of determination ≤7%). Conclusions: For the assessment of facial asymmetry in JIA patients, morphometric measurements originating from 3D-photographs seem to deliver results comparable to the clinical assessment methods. The asymmetry of the face, especially around the chin, appears to be related to asymmetrical TMJ destruction, but none of the investigated measurement methods of the face were able to reliably predict the TMJ affection. Thus, facial asymmetry assessments, both qualitatively in a clinical setting and quantitatively based on 3D-photographs, have limited diagnostic value for TMJ involvement in JIA patients.

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Cumulative Incidence of Orofacial Manifestations in Early Juvenile Idiopathic Arthritis: A Regional, Three‐Year Cohort Study

Stoustrup

Glerup

Bilgrau

et al. 2020

Arthritis Care & Research

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Objectives: To estimate the cumulative incidence of arthritis-induced orofacial symptoms, dysfunctions, and dentofacial deformities in growing individuals with juvenile idiopathic arthritis (JIA) in a 36 month regional cohort study, and to identify predictors for the development of arthritis-induced dentofacial deformities.Methods: Data was retrieved from the Aarhus JIA TMJ cohort register, which contains standardized, longitudinal, observational data regarding orofacial conditions in patients with JIA (n=1040). This regional cohort represents the majority of all subjects with JIA from the western part of Denmark between 1990 and 2016, regardless of temporomandibular joint (TMJ) arthritis status. Cumulative incidences of orofacial conditions were reported using Kaplan-Meier methods and predictors for dentofacial deformity was identified using Cox proportional hazard analysis.Results: Follow-up data from 351 subjects over thirty-six months was included in this study.Median age at first clinical examination was 6.6 years (25/75 centiles: 4.9 and 9.9 years).Orofacial symptoms and dysfunction were common findings at 36 months after the first clinical examination and approximately five years after JIA onset, with a cumulative incidence of 38% and 53%, respectively. Dentofacial deformities were found in 35% of

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Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: A systematic literature review

Cited by 58 publications

References 43 publications

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Quantitative analysis of facial asymmetry based on three-dimensional photography: a valuable indicator for asymmetrical temporomandibular joint affection in juvenile idiopathic arthritis patients?

Cumulative Incidence of Orofacial Manifestations in Early Juvenile Idiopathic Arthritis: A Regional, Three‐Year Cohort Study

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