OROFACIAL signs and symptoms are common in children with juvenile idiopathic arthritis (JIA). New data from the research team at Aarhus University, Denmark, suggests that approximately 30% of patients with JIA develop temporomandibular joint (TMJ) involvement before transitioning to adult care.
Mia Glerup and colleagues, Aarhus University, commented: “The past decade has seen growing attention to orofacial manifestations related to JIA,” and highlighted: “Orofacial manifestations of JIA may profoundly affect the subject’s general quality of life.”
To investigate the incidence of TMJ-involved orofacial conditions in JIA patients, a population-based cohort analysis was conducted. Data was extracted from the Aarhus JIA TMJ cohort database between January 2000–May 2018. The inclusion criteria were a diagnosis of JIA, an orofacial examination after the year 2000, and a minimum age of 16. The age of patients at the time of diagnosis, the category of JIA, laboratory results, rheumatoid factor, medications, and the number of active joints at baseline were recorded.
A total of 613 patients were included in the analysis and were followed for a mean clinical observation time of 4.0 years. Results indicated that there was a cumulative incidence of TMJ-associated JIA of 30.1%. Wider analysis revealed that 20.6% of the cohort experienced arthritis-induced dentofacial deformity, and 52% experienced dentofacial dysfunction. The following baseline variables were significantly associated with TMJ involvement: JIA onset at younger than 9 years of age, female sex, and antinuclear antibody positivity.
Glerup and colleagues summarised: “Our study documented that 30 percent of the total JIA cohort developed TMJ involvement before transition into adult care,” before adding that the present study “is the first population-based study using real-world data in the biologic era to report on the cumulative incidence of orofacial manifestations of JIA.” Thus, the results elucidate TMJ involvement and JIA-related dentofacial deformity are frequent complications. Future research, healthcare programmes, and JIA treatment should devote particular attention to this relationship.
