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Informationen aus Orthodontie & Kieferorthopädie 2017; 49(03): 193-197
DOI: 10.1055/s-0043-117678
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Juvenile idiopathische Arthritis (JIA) und das Kiefergelenk – Ein Update

Juvenile Idiopathic Arthritis (JIA) and the Temporomandibular Joint – An Update
Till E. Bechtold
1   Poliklinik für Kieferorthopädie, Universitätsklinik für Zahn-, Mund- und Kieferheilkunde, Tübingen
,
Ines M. Magunia
2   Kinderrheumatologie, Universitätskinderklinik, Tübingen
,
Jasmin Kümmerle-Deschner
2   Kinderrheumatologie, Universitätskinderklinik, Tübingen
,
Bernd Koos
1   Poliklinik für Kieferorthopädie, Universitätsklinik für Zahn-, Mund- und Kieferheilkunde, Tübingen
› Author Affiliations
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Publication History

Publication Date:
28 September 2017 (online)

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Zusammenfassung

Die juvenile idiopathische Arthritis (JIA), als häufigste rheumatische Erkrankung im Kindesalter, ist vielfach durch eine mögliche Kiefergelenkbeteiligung für das Fachgebiet der Kieferorthopädie relevant. Eine Kiefergelenkarthritis kann – wie nachfolgend ausgeführt – mitunter negativen Einfluss auf die orofaziale Entwicklung und Ausbildung von kraniofazialen Anomalien haben. Eine frühzeitige Erstdiagnose kann die Qualität des Behandlungsergebnisses deutlich begünstigen. Die in diesem Update zur JIA im Weiteren vorgestellten Empfehlungen fassen die interdisziplinären Arbeiten der internationalen Expertengruppe euroTMjoint der letzten Jahre zusammen. Im Vordergrund steht dabei auch die erstmalige internationale und interdisziplinäre Konsensusempfehlung für die orofaziale Untersuchung und Überwachung von Patienten mit JIA zur Vereinheitlichung klinischer und wissenschaftlicher Parameter sowie Früherkennung einer Kiefergelenkbeteiligung.

Neben der Kieferorthopädie umfasst die Therapie der JIA weitere Säulen, wie die medikamentöse Therapie durch Kinderrheumatologen, Physiotherapie, psychosoziale Begleitung sowie weitere Therapieverfahren. Eine enge interdisziplinäre Zusammenarbeit ist hier notwendig.

Abstract

Juvenile idiopathic arthritis (JIA) is the most frequent rheumatic disease during childhood. Multiple cases involve the temporomandibular joint (TMJ) and are therefore relevant to orthodontists. TMJ arthritis can negatively affect orofacial growth up to the development of craniofacial anomalies. An early initial diagnosis can optimize treatment outcome. In this update on JIA, we present the recommendations by the international task force euroTMjoint which shall for the first time establish an internationally accepted consensus on orofacial examination and follow-up of patients with JIA in order to standardize clinical and research parameters as well as to early detect involvement of the TMJ. Orthodontic treatment of JIA is part of a treatment concept including medical treatment by pediatric rheumatologists, physiotherapy, psychosocial care and other therapies. A well attuned interdisciplinary team is crucial for treatment success.

Schlüsselwörter

Juvenile idiopathische Arthritis (JIA) - Kiefergelenk - Gesichtswachstum - kraniofaziale Fehlbildungen - Diagnose - Krankheitsverlauf

Key words

Juvenile idiopathic arthritis (JIA) - temporomandibular joint (TMJ) - facial growth - craniofacial anomaly - diagnosis - follow-up
 

  • Literatur

  • 1 Kjellberg H. Juvenile chronic arthritis. Dentofacial morphology, growth, mandibular function and orthodontic treatment. (Review). Swed Dent J 1995; 109 Supplement 1-56
    PubMedGoogle Scholar
  • 2 Mericle PM, Wilson VK, Moore TL. et al. Effects of polyarticular and pauciarticular onset juvenile rheumatoid arthritis on facial and mandibular growth. J Rheumatol 1996; 23: 159-165
    PubMedGoogle Scholar
  • 3 Sidiropoulou-Chatzigianni S, Papadopoulos MA, Kolokithas G. Dentoskeletal morphology in children with juvenile idiopathic arthritis compared with healthy children. J Orthod 2001; 28: 53-58
    CrossrefPubMedGoogle Scholar
  • 4 Twilt M, Schulten AJM, Nicolaas P. et al. Facioskeletal changes in children with juvenile idiopathic arthritis. Ann Rheum Dis 2006; 65: 823-825
    CrossrefPubMedGoogle Scholar
  • 5 Billiau AD, Hu Y, Verdonck A. et al. Temporomandibular joint arthritis in juvenile idiopathic arthritis: Prevalence, clinical and radiological signs, and relation to dentofacial morphology. J Rheumatol 2007; 34: 1925-1933
    PubMedGoogle Scholar
  • 6 Küseler A, Pedersen TK, Herlin T. et al. Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol 1998; 25: 1406-1412
    PubMedGoogle Scholar
  • 7 Tzaribachev N, Fischer-Brandies H, Koos B. Chronische autoimmune Arthritis der Kiefergelenke - interdisziplinäre Therapieansätze. Informationen aus Orthodontie & Kieferorthopädie 2013; 45: 141-146
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Stoustrup P, Koos B. Clinical craniofacial examination of patients with juvenile idiopathic arthritis. Seminars in Orthodontics 2015; 21: 94-101
    CrossrefPubMedGoogle Scholar
  • 9 Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Swed Dent J 1974; 67: 101-121
    PubMedGoogle Scholar
  • 10 List T, Wahlund K, Wenneberg B. et al. TMD in children and adolescents: prevalence of pain, gender differences, and perceived treatment need. J Orofac Pain 1999; 13: 9-20
    PubMedGoogle Scholar
  • 11 Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6: 301-355
    PubMedGoogle Scholar
  • 12 Schiffman E, Ohrbach R, Truelove E. et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache 2014; 28: 6-27
    CrossrefPubMedGoogle Scholar
  • 13 Stoustrup P, Twilt M, Spiegel L. et al. Clinical orofacial examination in juvenile idiopathic arthritis: international consensus-based recommendations for monitoring patients in clinical practice and research studies. J Rheumatol 2017; 44: 326-333
    CrossrefPubMedGoogle Scholar
  • 14 Leksell E, Ernberg M, Magnusson B. et al. Orofacial pain and dysfunction in children with juvenile idiopathic arthritis: a case–control study. Scand J Rheumatol 2012; 41: 375-378
    CrossrefPubMedGoogle Scholar
  • 15 Cedströmer A-L, Andlin-Sobocki A, Berntson L. et al. Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis – an observational study. Pediatr Rheumatol Online J 2013; 11: 37
    CrossrefPubMedGoogle Scholar
  • 16 Bakke M, Zak M, Jensen BL. et al. Orofacial pain, jaw function, and temporomandibular disorders in women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 406-414
    CrossrefPubMedGoogle Scholar
  • 17 Twilt M, Mobers SMLM, Arends LR. et al. Temporomandibular involvement in juvenile idiopathic arthritis. J Rheumatol 2004; 31: 1418-1422
    PubMedGoogle Scholar
  • 18 Engström A-L, Wänman A, Johansson A. et al. Juvenile arthritis and development of symptoms of temporomandibular disorders: A 15-year prospective cohort study. J Orofac Pain 2007; 21: 120-126
    PubMedGoogle Scholar
  • 19 Stoustrup P, Kristensen KD, Verna C. et al. Orofacial symptoms related to temporomandibular joint arthritis in juvenile idiopathic arthritis: smallest detectable difference in self-reported pain intensity. J Rheumatol 2012; 39: 2352-2358
    CrossrefPubMedGoogle Scholar
  • 20 Pedersen TK, Küseler A, Gelineck J. et al. A prospective study of magnetic resonance and radiographic imaging in relation to symptoms and clinical findings of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol 2008; 35: 1668-1675
    PubMedGoogle Scholar
  • 21 Müller L, Kellenberger CJ, Cannizzaro E. et al. Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology (Oxford) 2009; 48: 680-685
    CrossrefPubMedGoogle Scholar
  • 22 Stoll ML, Sharpe T, Beukelman T. et al. Risk factors for temporomandibular joint arthritis in children with juvenile idiopathic arthritis. J Rheumatol 2012; 39: 1880-1887
    CrossrefPubMedGoogle Scholar
  • 23 Abramowicz S, Susarla HK, Kim S. et al. Physical findings associated with active temporomandibular joint inflammation in children with juvenile idiopathic arthritis. J Oral Maxillofac Surg 2013; 71: 1683-1687
    CrossrefPubMedGoogle Scholar
  • 24 Stoustrup P, Kristensen KD, Verna C. et al. Intra-articular steroid injection for temporomandibular joint arthritis in juvenile idiopathic arthritis: A systematic review on efficacy and safety. Semin Arthritis Rheum 2013; 43: 63-70
    CrossrefPubMedGoogle Scholar
  • 25 Larheim TA, Höyeraal HM, Stabrun AE. et al. The temporomandibular joint in juvenile rheumatoid arthritis: radiographic changes related to clinical and laboratory parameters in 100 children. Scand J Rheumatol 1982; 11: 5-12
    PubMedGoogle Scholar
  • 26 Arvidsson LZ, Flatø B, Larheim TA. Radiographic TMJ abnormalities in patients with juvenile idiopathic arthritis followed for 27 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 114-123
    CrossrefPubMedGoogle Scholar
  • 27 McKay GM, Cox LA, Long BW. Imaging juvenile idiopathic arthritis: assessing the modalities. Radiol Technol 2010; 81: 318-327
    PubMedGoogle Scholar
  • 28 Munir S, Patil K, Miller E. et al. Juvenile idiopathic arthritis of the axial joints: a systematic review of the diagnostic accuracy and predictive value of conventional MRI. Am J Roentgenol 2014; 202: 199-210
    CrossrefPubMedGoogle Scholar
  • 29 von Kalle T, Winkler P, Stuber T. Contrast-enhanced MRI of normal temporomandibular joints in children—is there enhancement or not?. Rheumatology (Oxford) 2013; 52: 363-367
    CrossrefPubMedGoogle Scholar
  • 30 Küseler A, Pedersen TK, Gelineck J. et al. A 2 year followup study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol 2005; 32: 162-169
    PubMedGoogle Scholar
  • 31 Arabshahi B, Dewitt EM, Cahill AM. et al. Utility of corticosteroid injection for temporomandibular arthritis in children with juvenile idiopathic arthritis. Arthritis Rheum 2005; 52: 3563-3569
    CrossrefPubMedGoogle Scholar
  • 32 Weiss PF, Arabshahi B, Johnson A. et al. High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum 2008; 58: 1189-1196
    CrossrefPubMedGoogle Scholar
  • 33 Koos B, Twilt M, Kyank U. et al. Reliability of clinical symptoms in diagnosing temporomandibular joint arthritis in juvenile idiopathic arthritis. J Rheumatol 2014; 41: 1871-1877
    CrossrefPubMedGoogle Scholar
  • 34 von Bremen J, Ruf S. Juvenile idiopathic arthritis—and now?. J Orofac Orthop 2012; 73: 265-276
    CrossrefPubMedGoogle Scholar
  • 35 Koyama E, Saunders C, Salhab I. et al. Lubricin is required for the structural integrity and post-natal maintenance of TMJ. J Dent Res 2014; 93: 663-670
    CrossrefPubMedGoogle Scholar
  • 36 Bechtold TE, Saunders C, Decker RS. et al. Osteophyte formation and matrix mineralization in a TMJ osteoarthritis mouse model are associated with ectopic hedgehog signaling. Matrix Biol 2016; 52-54: 339-354
    CrossrefPubMedGoogle Scholar
  • 37 Enlow DH, Hans MG. Essentials of facial growth. Enlow DH, Hans MG. Editors. 1996. Philadelphia: Saunders; 1-78
    Google Scholar
  • 38 Kristensen KD, Stoustrup P, Küseler A. et al. Quantitative histological changes of repeated antigen-induced arthritis in the temporomandibular joints of rabbits treated with intra-articular corticosteroid. J Oral Pathol Med 2008; 37: 437-444
    CrossrefPubMedGoogle Scholar
  • 39 Kristensen KD, Hauge EM, Dalstra M. et al. Association between condylar morphology and changes in bony microstructure and sub-synovial inflammation in experimental temporomandibular joint arthritis. J Oral Pathol Med 2011; 40: 111-120
    CrossrefPubMedGoogle Scholar
  • 40 Stoll ML, Sharpe T, Beukelman T. et al. Intra-articular corticosteroid injections to the temporomandibular joints are safe and appear to be effective therapy in children with juvenile idiopathic arthritis. J Oral Maxillofac Surg 2012; 70: 1802-1807
    CrossrefPubMedGoogle Scholar
  • 41 Ringold S, Torgerson TR, Egbert MA. et al. Intraarticular corticosteroid injections of the temporomandibular joint in juvenile idiopathic arthritis. J Rheumatol 2008; 35: 1157-1164
    PubMedGoogle Scholar
  • 42 Niehues T, Guellac N. Aktualisierte, interdisziplinäre S2-Therapieleitlinie der Juvenile idiopathischen Arthritis (2. Auflage). www.awmf.org
    PubMed
  • 43 Stoll ML, Morlandt AB, Teerawattanapong S. et al. Safety and efficacy of intra-articular infliximab therapy for treatment-resistant temporomandibular joint arthritis in children: a retrospective study. Rheumatology (Oxford) 2013; 52: 554-559
    CrossrefPubMedGoogle Scholar
  • 44 Bello S. Intra-articular therapy with tumor necrosis factor-α antagonists: an update. Reumatismo 2014; 65: 257-263
    CrossrefPubMedGoogle Scholar