Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review

Fuente, Sami el Assar de la; Angenete, Oskar; Jellestad, Stig; Tzaribachev, Nikolay; Koos, Bernd; Rosendahl, Karen

doi:10.1016/j.jcms.2016.01.014

Cited by 28 publications

(17 citation statements)

References 106 publications

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“…Limited reports exist on the relationship between 3D facial photographs of JIA patients and presumed uni-or bilateral TMJ involvement established on cephalograms [14] or panoramic films [29,30]. As outlined in the introduction, scientific literature has produced ample and rich evidence that these two-dimensional radiographs fail to reflect TMJ lesions and their extent reliably [7]. This has been acknowledged by the authors of the previous reports who stressed the pivotal necessity of studies that would base the TMJ involvement on MRI diagnostics [29].…”

Section: Discussionmentioning

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%

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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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Section: Discussionmentioning

confidence: 99%

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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“…It combines clinical, laboratory and radiologic data from a large number of children with juvenile idiopathic arthritis, to validate, refine and further explore different imaging techniques used for the assessment of temporomandibular joint involvement in children with juvenile idiopathic arthritis. The focus is on advanced MRI techniques and image analysis [ 17 ].…”

Section: Multi-modality Groupsmentioning

confidence: 99%

Imaging in juvenile idiopathic arthritis — international initiatives and ongoing work

et al. 2018

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“… 4,5 Unfortunately, pain is a rare symptom of TMJ involvement and frequently the clinical assessment of this joint is not enough to formulate a diagnosis. 6 …”

Section: Introductionmentioning

confidence: 99%

An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study

Tonni

Borghesi

Tonesi

et al. 2021

Dentomaxillofacial Radiology

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Objectives: As it is well known, the diagnosis of temporomandibular joint (TMJ) involvement in patients affected by Juvenile Idiopathic Arthritis (JIA) is important to avoid the impairment of mandibular growth. In this context, Magnetic Resonance Imaging (MRI) is the gold-standard for detection of TMJ involvement, however it is expensive and requires patients’ collaboration. The aim of this study was to evaluate if ultrasound may be used as an alternative tool to investigate the acute signs of TMJ involvement in JIA patients. Methods: Lateral periarticular space (LPAS) and joint effusion were evaluated by ultrasound in a study Group A of 8 JIA children (11.6±3.5 years old) with 14 TMJs involved, as confirmed by MRI, and in a control Group B of 7 healthy children (9.3±1.2 years old) without temporomandibular disorders (TMD). The LPAS width values were compared between the two groups using the Mann–Whitney test. The ultrasound images of the JIA group were then matched with the corresponding MR images; the Spearman Rank Correlation test and the Bland–Altman test were used to evaluate the differences. Results: The LPAS values in Group A were statistically significantly higher than those in Group B (p < 0.001). There was no overlap of the LPAS values confidence intervals (CIs) between the two groups. No signs of joint effusion were identified in groups A and B. The Spearman test applied to the values of LPAS measured in ultrasound and the corresponding MR images showed a proportional positive correlation with a ρ of 0.623 and a p < 0.05. Conclusions: Ultrasound can detect differences in the TMJ features between JIA patients and healthy patients and it might be used as a follow-up tool in the assessment of TMJ involvement in subject affected by JIA.

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Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review

Cited by 28 publications

References 106 publications

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

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

Imaging in juvenile idiopathic arthritis — international initiatives and ongoing work

An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study

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