Dental and facial characteristics of patients with juvenile idiopathic arthritis.
OBJECTIVE
It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital.


METHODS
Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children.


RESULTS
The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P =.032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P =.055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P =.017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P =.015).


CONCLUSIONS
This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health.
Dentistry Division, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, SP, Brazil.
Cynthia
C
Savioli
Clovis A A
CA
Silva
Lin H
LH
Ching
Lucia M M A
LM
Campos
Eliane F B G
EF
Prado
José Tadeu T
JT
Siqueira
D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology; D003766:Dental Occlusion; D005157:Facial Pain; D019066:Facies; D005260:Female; D005882:Gingival Diseases / Q000209:etiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D013705:Temporomandibular Joint Disorders / Q000209:etiology*