Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis.
OBJECTIVE
Temporomandibular joint (TMJ) involvement is a frequent feature in cross-sectional prevalence studies among patients with juvenile idiopathic arthritis (JIA). In this followup study, patients were reviewed after 5 years to study the course of TMJ involvement in relation to disease characteristics.


METHODS
Children with JIA from a previous study on TMJ involvement were included. A rheumatologic evaluation including the 6 parameters of the JIA core set and an orthodontic evaluation including an orthopantomogram (OPT) were performed. OPTs were scored according to Rohlin's grading system (grades 0-5).


RESULTS
The overall prevalence of patients with condylar alterations decreased from 49% to 40%. Improvement of the alterations was seen in 69% of the initially affected condyles, and consequently improvement was seen in 83% of the initially affected patients. Normalization of the alterations was seen in 67% of the improved condyles, and consequently in 44% of the patients. This proves that the condyle has a regenerative capacity. Improvement was related to low disease activity and a less extensive therapeutic regimen.


CONCLUSIONS
In patients with JIA, condylar alterations can improve and even regenerate. Condylar improvement is associated with a low disease activity.
Twilt
Marinka
M
Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands. m.twilt@erasmusmc.nl
Schulten
Alcuin J M
AJ
Verschure
Femke
F
Wisse
Lauke
L
Prahl-Andersen
Birte
B
van Suijlekom-Smit
Lisette W A
LW
D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D013997:Time Factors