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Research article
Johannes Fischer
Universitetet i Bergen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9000-2816
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background. Children and adolescents with JIA may suffer pain from temporomandibular disorder (TMD) and routines for the assessment of temporomandibular joint (TMJ) pain for the health and dental care are lacking. The aims were to examine the prevalence of TMD in children and adolescents with juvenile idiopathic arthritis (JIA) as compared to their healthy peers and to examine potential associations between JIA and TMD.
Methods. This comparative cross-sectional study is part of a longitudinal multicenter study performed during 2015 - 2020, including 228 children and adolescents aged 4-16 years, with a diagnosis of JIA according to the ILAR criteria. This sub-study draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Participants with JIA were matched with healthy controls according to gender, age, and center site. Calibrated examiners performed the clinical oral examinations according to a standardized protocol, including shortened versions of diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJ`s.
Results. In our cohort of 221 participants with JIA and corresponding controls, 88 participants with JIA (39.8%) and 25 (11.3%) controls revealed TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p<0.001). Vertical unassisted jaw movement was lower in JIA than in controls; mean 46.2 mm vs. 49.0 mm, respectively (p <0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs (sDMARDs) and biologic (bDMARDs) presented with painful masticatory muscle and TMJs at palpation.
Conclusion. Symptoms or clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in JIA.
Keywords
Juvenile idiopathic arthritis, Temporomandibular joint arthritis, Temporomandibular disorder, Temporomandibular joint disease, Children and adolescents
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Oral Health.
No community comments so far
Editorial decision: Accept
On 25 Aug, 2020
Editor assigned
On 21 Aug, 2020
Submission checks complete
On 20 Aug, 2020
Editor invited
On 20 Aug, 2020
Version 1
Posted 09 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 05 Aug, 2020
Review #3 received
Received 31 Jul, 2020
Review #2 received
Received 12 Jul, 2020
Review #1 received
Received 12 Jul, 2020
Reviewer #4 agreed
On 10 Jul, 2020
Reviewers invited
Invitations sent on 09 Jul, 2020
Reviewer #1 agreed
On 09 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Reviewer #3 agreed
On 09 Jul, 2020
Editor assigned
On 30 Jun, 2020
First submitted
On 29 Jun, 2020
Submission checks complete
On 29 Jun, 2020
Editor invited
On 29 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Dentistry
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See the published version of this preprint at BMC Oral Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Johannes Fischer
Universitetet i Bergen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9000-2816
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Oral Health.
No community comments so far
Editorial decision: Accept
On 25 Aug, 2020
Editor assigned
On 21 Aug, 2020
Submission checks complete
On 20 Aug, 2020
Editor invited
On 20 Aug, 2020
Version 1
Posted 09 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 05 Aug, 2020
Review #3 received
Received 31 Jul, 2020
Review #2 received
Received 12 Jul, 2020
Review #1 received
Received 12 Jul, 2020
Reviewer #4 agreed
On 10 Jul, 2020
Reviewers invited
Invitations sent on 09 Jul, 2020
Reviewer #1 agreed
On 09 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Reviewer #3 agreed
On 09 Jul, 2020
Editor assigned
On 30 Jun, 2020
First submitted
On 29 Jun, 2020
Submission checks complete
On 29 Jun, 2020
Editor invited
On 29 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Dentistry
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Oral Health.
Background. Children and adolescents with JIA may suffer pain from temporomandibular disorder (TMD) and routines for the assessment of temporomandibular joint (TMJ) pain for the health and dental care are lacking. The aims were to examine the prevalence of TMD in children and adolescents with juvenile idiopathic arthritis (JIA) as compared to their healthy peers and to examine potential associations between JIA and TMD.
Methods. This comparative cross-sectional study is part of a longitudinal multicenter study performed during 2015 - 2020, including 228 children and adolescents aged 4-16 years, with a diagnosis of JIA according to the ILAR criteria. This sub-study draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Participants with JIA were matched with healthy controls according to gender, age, and center site. Calibrated examiners performed the clinical oral examinations according to a standardized protocol, including shortened versions of diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJ`s.
Results. In our cohort of 221 participants with JIA and corresponding controls, 88 participants with JIA (39.8%) and 25 (11.3%) controls revealed TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p<0.001). Vertical unassisted jaw movement was lower in JIA than in controls; mean 46.2 mm vs. 49.0 mm, respectively (p <0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs (sDMARDs) and biologic (bDMARDs) presented with painful masticatory muscle and TMJs at palpation.
Conclusion. Symptoms or clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in JIA.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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