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Orofacial dysfunctions reported in more than half of patients with early-course JIA
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Orofacial symptoms are present in approximately 38% of patients with juvenile idiopathic arthritis, with orofacial dysfunctions prevalent in an estimated 56% of patients early in the disease course, according to findings published in Arthritis Care & Research.
“Few prospective studies have elucidated the incidence rates of orofacial conditions in non-selected JIA cohorts,” Peter Stoustrup, DDS, PhD, of Aarhus University, Denmark, and colleagues wrote. “The establishment of accurate population-based estimates of [temporomandibular joint] arthritis-related orofacial conditions and the identification of predictors for dentofacial deformities would improve risk assessment, family counseling, and the development of standardized interdisciplinary treatment approaches combining the efforts of pediatric rheumatologists, orthodontists, maxillofacial surgeons, and orofacial pain specialists.”
To estimate the total incidence of orofacial symptoms and dysfunctions caused by arthritis, as well as dentofacial deformities in those with still-developing skeletons, among patients with JIA, Stoustrup and colleagues reviewed data from the Aarhus JIA TMJ cohort register. According to the researchers, this register contains standardized, longitudinal, observational data on 1,040 patients with JIA at Aarhus University’s Regional Specialist Craniofacial Clinic between 1990 and May 2016.
Stoustrup and colleagues retrieved 36-month follow-up data on 351 patients aged younger than 14 years with a diagnosis of JIA. In addition, included patients had completed their first clinical visit in 2000 or later and at least 3 years of observation time, with a minimum of one clinical orofacial examination each year. The researchers estimated cumulative incidences of orofacial conditions using KaplanMeier methods, and reported predictors of dentofacial deformity with Cox proportional hazards.
According to the researchers, the cumulative incidence of orofacial symptoms was 38% at 36 months after initial clinical examination, approximately 5 years after JIA disease onset. For orofacial dysfunction during the same follow-up period, the cumulative incidence was 53%. In addition, dentofacial deformaties were reported in 35% of patients at 36 months. These deformities were significantly associated with orofacial dysfunction.
“We believe that the findings presented here will further aid the management of TMJ arthritis, enabling risk assessment of orofacial complication to JIA,” Stoustrup and colleagues wrote. “We found substantial cumulative incidences of orofacial symptoms and orofacial dysfunctions at a 36-month follow-up, and it is noteworthy that approximately one-third of these patients had arthritis-induced dentofacial deformity associated only with the presence of orofacial dysfunction.” – by Jason Laday
Disclosures : The researchers report no relevant financial disclosures.
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