Temporomandibular Joint Disorders among Patients with Juvenile Idiopathic Arthritis

Abstract

ABSTRACT:BACKGROUND: Juvenile idiopathic arthritis (JIA) is an immune mediated chronic disease. In its most severe clinical form, JIA may show localized and/or systemic and oral complications. This may result in variable growth and developmental anomalies. As a result, it is not uncommon for JIA patients to present with skeletal Class II and open bite malocclusions.OBJECTIVE:This study was conducted to assess temporomandibular joint (TMJ) among patients with JIA.MATERIALS AND METHODS: A cross sectional study was conducted among JIA patients attending Baghdad Teaching Hospital from November 2014 to April 2015. All patients underwent a clinical evaluation of their TMJ condition. TMJ disorder was assessed by using Helkimo’s index (1974a), and distribution of TMJ disorders was assessed according to the age, gender, duration of illness and types of medication.RESULTS: The mean age of JIA patients was 17.59±9.63 years old and mean Illness duration of 8.45± 9.29 years. High percentage of patients (93.8%) presented with clinical dysfunction of TMJ (CDI). 22 patients with JIA (27.16%) presented with severe clinical dysfunction, 19 patients with JIA (23.46%) presented with moderate clinical dysfunction and 35 patients (43.21%) presented with mild clinical dysfunction of TMJ. No significant difference in mean value of CDI according to age and duration of illness. Females were affected by clinical dysfunctional index of TMJ more than males, but statistically non- significant. The highest mean value of CDI was among patients treated with prednisolone, while patients treated with combination of drugs were the least affected.CONCLUSION: This study confirms that patients with JIA have a high incidence of TMJ dysfunction. The systemic effect of disease may impact on development of TMJ and facial growth. Close supervision is required to JIA patients for orthodontic intervention need, regular dental care, and TMJ evaluation.