Patients with juvenile idiopathic arthritis (JIA) demonstrated increased incidence and risk for developing temporomandibular joint disorders and craniofacial deformities, according to study findings published in International Journal of Oral and Maxillofacial Surgery.

Researchers conducted a retrospective cohort study in Taiwan to analyze the incidence and risk for developing JIA-associated temporomandibular joint disorders and craniofacial deformities. They obtained data from the Longitudinal Health Insurance Dataset between 1999 and 2013, and compared 2791 patients newly diagnosed with JIA with 11,164 individuals without JIA in the control group.

Overall, 142 participants developed a temporomandibular joint disorder, with 48 (1.72%) represented in the JIA group and 94 (0.84%) in the control group. Likewise, 374 individuals developed a craniofacial deformity, with 112 (4.01%) represented in the JIA group and 262 (2.35%) in the control group.

Patients with JIA showed higher incidence of temporomandibular joint disorders (incidence rate [IR]: 1.93; 95% CI, 1.46-2.57) and craniofacial deformity (IR: 4.58; 95% CI, 3.80-5.51) compared with the control group (IR: 0.94; 95% CI, 0.77-1.16 and IR: 2.66; 95% CI, 2.36-3.00, respectively).

The relative risk for developing temporomandibular joint disorders with concurrent JIA was 2.047 (95% CI, 1.446-2.898), while the relative risk for developing craniofacial deformities with JIA was 1.722 (95% CI, 1.380-2.148).

Study limitations included the retrospective nature of the study, as the registry did not have imaging data available which could determine severity of arthritis and affected joints leading to craniofacial sequelae. Potential delays in JIA diagnosis also impacted calculation of time from JIA diagnosis to onset of temporomandibular joint disorder or craniofacial deformity.

The study authors concluded, “Prospective studies with detailed information regarding JIA subtypes are warranted to validate findings in the present study so as to identify the necessity of regular follow-up and patient education…and to propose multidisciplinary guidelines for the management of craniofacial manifestations of JIA.”

Reference

Ma KSK, Thota E, Huang JY, Wei JCC, Resnick CM. Increased risk of temporomandibular joint disorders and craniofacial deformities in patients with juvenile idiopathic arthritis: a population-based cohort study. Int J Oral Maxillofac Surg. Published online May 19, 2022. doi:10.1016/j.ijom.2022.04.007