Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations

Carlsson, Alexandra Dimitrijevic; Wahlund, Kerstin; Kindgren, Erik; Johansson, Carin Starkhammar; Alstergren, Per

doi:10.1186/s12969-019-0385-7

Cited by 17 publications

(26 citation statements)

References 39 publications

(44 reference statements)

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“…Two of the patients had a diagnosis of chronic pain syndrome, and a third had concerning features suggestive of chronic pain syndrome, which is associated with chronic, widespread pain, and commonly involve other temporomandibular disorders. There is evidence that orofacial pain in adolescents with JIA can be associated with stress, depression and catastrophizing [23], and therefore can be difficult to discern TMJ involvement versus TMJ disorder. For the patients in this cohort, all had isolated worsening of TMJ symptoms with MRI evidence of chronic damage which is more suggestive of TMJ involvement.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis

2020

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Background: Temporomandibular joint (TMJ) arthritis and involvement is commonly seen in Juvenile Idiopathic Arthritis (JIA). Therapy includes conservative measures, but also includes intraarticular corticosteroid injections (IASI) and systemic immunosuppressive therapy. Despite aggressive medical therapy, some patients develop arthritic changes and frank TMJ ankylosis that can result in persistent pain and limitation in range of motion (ROM). A surgical option is prosthetic TMJ replacement with concurrent correction of dentofacial deformities, which can be performed simultaneously. The objective of this study was to evaluate the outcomes of prosthetic TMJ replacement in a cohort of adolescent females with JIA and severe TMJ involvement. Methods: This is a retrospective case series that took place at one tertiary care center. Patients with a diagnosis of JIA who also underwent alloplastic TMJ replacement were identified through electronic medical record system (EMR) and reviewed. Chart review included analysis of all documents in the EMR, including demographic data, JIA history, surgical complications, ROM of TMJ measured by maximal incisal opening in millimeters (mm) and TMJ pain scores (4-point Likert scale: none, mild, moderate, severe) obtained pre-and postoperatively. Results: Five female patients, ages 15-17 year when TMJ replacement was performed, had nine total joints replaced with a post-operative follow-up period of 12-30 months. All patients had polyarticular, seronegative JIA and were treated with IASI and multiple immunosuppressive therapies without resolution of TMJ symptoms. One patient had bilateral TMJ ankylosis. Three of the five patients demonstrated significant dentofacial deformities, and all underwent simultaneous or staged orthognathic surgery. All patients had improvement in TMJ pain with most (80%) reporting no pain, and all had similar or improved ROM of their TMJ postoperatively. There was one delayed postoperative infection with Cutibacterium Acnes that presented 15 months after surgery and required removal and reimplantation of prosthesis.

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Section: Discussionmentioning

confidence: 99%

Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis

2020

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“…TMJ arthritis symptoms presents as mandibular micrognathia, anterior open bite, restricted mouth opening, jaw pain and stiffness (68) (Table 2). There is high prevalence of TMD in JIA as compared to RA (69).…”

Section: Juvenile Idiopathic Arthritis (Jia)mentioning

confidence: 91%

“…Chronic arthritis of one or more joints lasting 6 weeks or more in an adolescent under 16 years of age, which cannot be referred to any other cause is diagnosed as JIA (22,69). Complete medical history and physical evaluation is required.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

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Orofacial pain considerations in autoimmune disorders: narrative review

Singh¹,

George²,

Kalladka³

et al. 2024

Front Oral Maxillofac Med

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Immunity is an essential self-defensive mechanism comprised of biological structures and processes within an organism that protects it against invasive microorganism, viruses, malignancies and diseases (1,2). Malfunction of the immune system can cause the self-destruction of its own cells, tissues, and organs resulting in autoimmune diseases (AD) (2). Approximately, 5% of the population worldwide and 3% of US population suffer from AD imposing a significant burden of morbidity and mortality (1,3).Scientific research and literatures have provided substantial advancements in our understanding of human autoimmunity that have led to improvements in classification, diagnosis and management of the diseases (1-3). Tissue damage in AD is an exaggerated responses of the immune system towards self-antigens (1). Evidence suggests that antigens released by bacteria, viruses, toxins, blood, and tissue can trigger an

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“…Chronic pain persists longer than 3 months and is influenced by biological, social, and psychological factors (Landry et al, 2015). Children with conditions such as complex regional pain syndrome, chronic headaches, sickle cell disease, juvenile idiopathic arthritis, and fibromyalgia often experience pain (Carlsson et al, 2019; Reader et al, 2020; Weiss & Kashikar-Zuck, 2021; Weissmann & Uziel, 2016). Pain, or fear of experiencing pain, may limit activity participation, hindering successful engagement in meaningful activities and reducing quality of life (Fisher-Pipher & Kenyon, 2015).…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Occupational Therapy-Related Interventions for Pediatric Chronic Pain

Suder

DeBoth

Carrick

et al. 2022

OTJR: Occupation, Participation and Health

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Occupational therapists have distinct value providing pediatric chronic pain interventions (e.g., pain management, normalizing sensory responses, increasing participation); however, limited evidence exists. This review appraised empirical studies on occupational therapy pediatric chronic pain management. Three reviewers independently screened 2,401 titles, 250 abstracts, and 71 full-text sources for studies published in English, after 2008, and with sample sizes >10, participants <18 years, with chronic pain >3 months, and outcomes related to pain/function. Studies were assessed for risk of bias. The review included 23 studies on psychological, interprofessional, virtual/telehealth, or biomechanical management, demonstrating significant decreases in pain/disability. Most studies had high risk of bias for lack of randomization and control groups, and homogeneous sampling. The occupational therapists’ role in chronic pain interventions is still unclear. Research including larger, heterogenous samples is warranted to examine occupational therapy’s specific role providing pain interventions as part of a team.

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Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations

Cited by 17 publications

References 39 publications

Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis

Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis

Orofacial pain considerations in autoimmune disorders: narrative review

A Systematic Review of Occupational Therapy-Related Interventions for Pediatric Chronic Pain

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