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Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis
Author(s) -
Frid Paula,
Nordal Ellen,
Bovis Francesca,
Giancane Gabriella,
Larheim Tore A.,
Rygg Marite,
Pires Marafon Denise,
De Angelis Donato,
Palmisani Elena,
Murray Kevin J.,
Oliveira Sheila,
Simonini Gabriele,
Corona Fabrizia,
Davidson Joyce,
Foster Helen,
Steenks Michel H.,
Flato Berit,
Zulian Francesco,
Baildam Eileen,
Saurenmann Rotraud K.,
Lahdenne Pekka,
Ravelli Angelo,
Martini Alberto,
Pistorio Angela,
Ruperto Nicolino
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23003
Subject(s) - medicine , arthritis , quality of life (healthcare) , disease , physical therapy , rheumatology , logistic regression , temporomandibular joint , odds ratio , dentistry , nursing
Objective 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. Methods 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. Results 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. Conclusion 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.