Normal magnetic resonance appearances of the temporomandibular joints in children and young adults aged 2–18 years

Angenete, Oskar; Augdal, Thomas A.; Jellestad, Stig; Rygg, Marite; Rosendahl, Karen

doi:10.1007/s00247-017-4048-x

Cited by 11 publications

(11 citation statements)

References 27 publications

(51 reference statements)

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“…Both studies depicted numerous CBCT scans with distinct anterior condylar flattening but neither of them analysed nor particularly highlighted this flattening. We would argue that this condylar flattening might represent normal variations, as previously shown in several studies [38][39][40]. In their recent study of panoramic radiographs of 65 children (mean age 12 years old), Cedströmer and colleagues pointed out that even minor bony deformities might hamper craniofacial development [41].…”

Section: Discussionmentioning

confidence: 67%

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

et al. 2021

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Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from temporomandibular disorder (TMD). Due to this, imaging diagnosis is crucial in JIA with non-symptomatic TM joint (TMJ) involvement. The aim of the study was to examine the association between clinical TMD signs/symptoms and cone-beam computed tomography (CBCT) findings of TMJ structural deformities in children and adolescents with JIA. Methods This cross-sectional study is part of a longitudinal prospective multi-centre study performed from 2015–2020, including 228 children and adolescents aged 4–16 years diagnosed with JIA, according to the International League of Associations for Rheumatology (ILAR). For this sub-study, we included the Bergen cohort of 72 patients (32 female, median age 13.1 years, median duration of JIA 4.5 years). Clinical TMD signs/symptoms were registered as pain on palpation, pain on jaw movement, and combined pain of those two. The severity of TMJ deformity was classified as sound (no deformity), mild, or moderate/severe according to the radiographic findings of CBCT. Results Of 72 patients, 21 (29.2%) had pain on palpation at and around the lateral pole, while 41 (56.9%) had TMJ pain upon jaw movement and 26 (36.1%) had pain from both. Of 141 TMJs, 18.4% had mild and 14.2% had moderate/severe structural deformities visible on CBCT. CBCT findings were not significantly associated with either the pain on palpation or the pain on jaw movement. A significant difference was found between structural deformities in CBCT and the combined pain outcome (pain at both palpation and movement) for both TMJs for the persistent oligoarticular subtype (p = 0.031). Conclusions There was no association between painful TMD and CBCT imaging features of the TMJ in patients with JIA, but the oligoarticular subtype of JIA, there was a significant difference associated with TMJ pain and structural CBCT deformities.

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Section: Discussionmentioning

confidence: 67%

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

et al. 2021

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“…In the present study, the most precise MRI marker suggestive of osteochondral damage was condylar volume on a 0-1 scale; 0 being within normal and 1 representing a clearly deformed condyle in the sagittal and/or coronal views, a feature not seen in children without JIA (14,19,28).…”

Section: Osteochondral Domainmentioning

confidence: 49%

“…We have previously shown that a mildly flattened condyle is seen in around 20% of children without JIA, and as such represents a normal variation rather than early destructive change (19). Moreover, we experienced that both condylar irregularities and erosions may be present before severe condylar flattening, thus biasing a progressive system.…”

Section: Osteochondral Domainmentioning

confidence: 89%

“…uvenile idiopathic arthritis (JIA) is a chronic rheumatic disease of unknown origin, with an onset before the age of 16 and a reported incidence of 15 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) per 100,000 children/year in the Nordic countries (1). In patients with JIA, the temporomandibular joint (TMJ) is affected in 39-78% (2)(3)(4)(5) depending on definitions used for involvement, disease duration, and on the methods used for ascertainment.…”

mentioning

confidence: 99%

“…The accuracy of clinical findings and clinical monitoring of the disease course, both active inflammation and permanent damage, is under debate (16,17) and much effort has been made during the past years to establish a valid, MRI-based imaging protocol and classification system. However, methodological difficulties, including lack of references for normal findings, low image resolution and imprecise scoring systems have led to both over-and underreporting of signs of pathology (18,19). For example, Stoll and colleagues, in a study of 35 patients with JIA and 122 controls without JIA, demonstrated a significant overlap between the two groups with respect to MR findings thought to be suggestive of active disease (20).…”

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confidence: 99%

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MRI in the Assessment of TMJ-Arthritis in Children with JIA; Repeatability of a Newly Devised Scoring System

et al. 2022

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Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus‐Based Recommendations

Stoustrup

Resnick

Abramowicz

et al. 2022

Arthritis & Rheumatology

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Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management. We undertook this study to develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA, and to create a future research agenda related to management of TMJ arthritis in children with JIA. Recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during 2 consensus meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists, and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study. Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to diagnosis (n = 4), treatment of TMJ arthritis (active TMJ inflammation) (n = 2), treatment of TMJ dysfunction and symptoms (n = 3), treatment of arthritis-related dentofacial deformity (n = 2), and other aspects related to JIA (n = 1). Additionally, a future interdisciplinary research agenda was developed. These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA.

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Normal magnetic resonance appearances of the temporomandibular joints in children and young adults aged 2–18 years

Cited by 11 publications

References 27 publications

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT

MRI in the Assessment of TMJ-Arthritis in Children with JIA; Repeatability of a Newly Devised Scoring System

Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus‐Based Recommendations

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