title: Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis.
abstract: To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants.
  
  
  
  This study is based on a cross-sectional cohort of 3,343 children with JIA and 3,409 healthy peers, enrolled in the Pediatric Rheumatology International Trials Organisation HRQOL study or in the methotrexate trial. Potential determinants of TMJ involvement included demographic, disease activity, disability, and HRQOL measures selected through univariate and multivariable logistic regression.
  
  
  
  Clinical TMJ involvement was observed in 387 of 3,343 children with JIA (11.6%). Children with TMJ involvement, compared to those without, more often had polyarticular disease course (95% versus 70%), higher Juvenile Arthritis Disease Activity Score (odds ratio [OR] 4.6), more disability, and lower HRQOL. Children with TMJ involvement experienced clearly more disability and lower HRQOL compared to their healthy peers. The multivariable analysis showed that cervical spine involvement (OR 4.6), disease duration >4.4 years (OR 2.8), and having more disability (Childhood Health Assessment Questionnaire Disability Index >0.625) (OR 1.6) were the most important determinants for TMJ involvement.
  
  
  
  Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration.
authors: University Hospital of North Norway, UiT The Arctic University of Norway, and Public Dental Competence Center of Northern Norway, Tromsø, Norway.
authors: Paula
authors: 0000-0002-7492-3479
authors: P
authors: Frid
authors: University Hospital of North Norway, and UiT The Arctic University of Norway, Tromsø, Norway.
authors: Ellen
authors: E
authors: Nordal
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Francesca
authors: F
authors: Bovis
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Gabriella
authors: G
authors: Giancane
authors: UiT The Arctic University of Norway, Tromsø, and University of Oslo, Oslo, Norway.
authors: Tore A
authors: TA
authors: Larheim
authors: Norwegian University of Science and Technology and St. Olavs University Hospital, Trondheim, Norway.
authors: Marite
authors: M
authors: Rygg
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Denise
authors: D
authors: Pires Marafon
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Donato
authors: D
authors: De Angelis
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Elena
authors: E
authors: Palmisani
authors: Princess Margaret Hospital for Children, Perth, Australia.
authors: Kevin J
authors: KJ
authors: Murray
authors: Universidade Federal do Rio de Janeiro, and Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro, Brazil.
authors: Sheila
authors: S
authors: Oliveira
authors: Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
authors: Gabriele
authors: G
authors: Simonini
authors: Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
authors: Fabrizia
authors: F
authors: Corona
authors: Royal Hospital for Sick Children, Glasgow, UK.
authors: Joyce
authors: J
authors: Davidson
authors: Newcastle University, Newcastle Hospitals NHS Foundation Trust, and Great North Children's Hospital, Newcastle Upon Tyne, UK.
authors: Helen
authors: H
authors: Foster
authors: University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Michel H
authors: MH
authors: Steenks
authors: Oslo University Hospital and University of Oslo, Oslo, Norway.
authors: Berit
authors: B
authors: Flato
authors: Clinica Pediatrica, Padova, Italy.
authors: Francesco
authors: F
authors: Zulian
authors: Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
authors: Eileen
authors: E
authors: Baildam
authors: Kantonsspital Winterthur, Winterthur, Switzerland.
authors: Rotraud K
authors: RK
authors: Saurenmann
authors: Children's Hospital and Helsinki University Central Hospital, Helsinki, Finland.
authors: Pekka
authors: P
authors: Lahdenne
authors: Università di Genova, Istituto Giannina Gaslini, and PRINTO Coordinating Center, Genoa, Italy.
authors: Angelo
authors: A
authors: Ravelli
authors: Università di Genova, Istituto Giannina Gaslini, and PRINTO Coordinating Center, Genoa, Italy.
authors: Alberto
authors: A
authors: Martini
authors: Istituto Giannina Gaslini, Genoa, Italy.
authors: Angela
authors: A
authors: Pistorio
authors: Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy.
authors: Nicolino
authors: N
authors: Ruperto
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013704:Temporomandibular Joint / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*