Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids

Nicky A. Mandall, Robin Gray, Kevin D. O'Brien, Eileen Baildam, Tatiana MacFarlane, Joyce Davidson, John Sills, Helen Foster, Janet Gardner-Medwin, Ann Garrahy, Declan Millett, Rye Mattick, Tanya Walsh, Steven Ward

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids.

Design: Cross-sectional screening.

Subjects and setting: Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK.

Method: Patients were screened clinically and radiographically for the presence of class II skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded.

Main outcome measures: Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids.

Results: The mean ANB values were 4·2 degrees (SD¿=¿2·9 degrees) in the oligoarticular group and 5·1 degrees (SD¿=¿3·8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern.

Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20%), except for crepitus and click which affected between 24 and 40% of JIA children. Radiographically, 57% of oligoarticular and 77% of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P¿=¿0·001).

Conclusions: Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.
Original languageEnglish
Pages (from-to)6-15
Number of pages10
JournalJournal of Orthodontics
Volume37
Issue number1
DOIs
Publication statusPublished - Mar 2010

Fingerprint

Juvenile Arthritis
Temporomandibular Joint
Adrenal Cortex Hormones
Signs and Symptoms
Temporomandibular Joint Dysfunction Syndrome
Arthralgia
Sample Size
Outcome Assessment (Health Care)
Clinical Trials
Pain
Therapeutics

Keywords

  • juvenile idiopathic arthritis
  • class II skeletal pattern
  • temporomandibular joint signs and symptoms
  • corticosteroid treatment

Cite this

Juvenile idiopathic arthritis (JIA) : a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids. / Mandall, Nicky A.; Gray, Robin; O'Brien, Kevin D.; Baildam, Eileen; MacFarlane, Tatiana; Davidson, Joyce; Sills, John; Foster, Helen; Gardner-Medwin, Janet; Garrahy, Ann; Millett, Declan; Mattick, Rye; Walsh, Tanya; Ward, Steven.

In: Journal of Orthodontics, Vol. 37, No. 1, 03.2010, p. 6-15.

Research output: Contribution to journalArticle

Mandall, NA, Gray, R, O'Brien, KD, Baildam, E, MacFarlane, T, Davidson, J, Sills, J, Foster, H, Gardner-Medwin, J, Garrahy, A, Millett, D, Mattick, R, Walsh, T & Ward, S 2010, 'Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids', Journal of Orthodontics, vol. 37, no. 1, pp. 6-15. https://doi.org/10.1179/14653121042831
Mandall, Nicky A. ; Gray, Robin ; O'Brien, Kevin D. ; Baildam, Eileen ; MacFarlane, Tatiana ; Davidson, Joyce ; Sills, John ; Foster, Helen ; Gardner-Medwin, Janet ; Garrahy, Ann ; Millett, Declan ; Mattick, Rye ; Walsh, Tanya ; Ward, Steven. / Juvenile idiopathic arthritis (JIA) : a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids. In: Journal of Orthodontics. 2010 ; Vol. 37, No. 1. pp. 6-15.
@article{39d7933284f74b1292f07ff82e33aec4,
title = "Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids",
abstract = "Objective: To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids. Design: Cross-sectional screening. Subjects and setting: Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK. Method: Patients were screened clinically and radiographically for the presence of class II skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded. Main outcome measures: Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids. Results: The mean ANB values were 4·2 degrees (SD¿=¿2·9 degrees) in the oligoarticular group and 5·1 degrees (SD¿=¿3·8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20{\%}), except for crepitus and click which affected between 24 and 40{\%} of JIA children. Radiographically, 57{\%} of oligoarticular and 77{\%} of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P¿=¿0·001). Conclusions: Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.",
keywords = "juvenile idiopathic arthritis, class II skeletal pattern, temporomandibular joint signs and symptoms, corticosteroid treatment",
author = "Mandall, {Nicky A.} and Robin Gray and O'Brien, {Kevin D.} and Eileen Baildam and Tatiana MacFarlane and Joyce Davidson and John Sills and Helen Foster and Janet Gardner-Medwin and Ann Garrahy and Declan Millett and Rye Mattick and Tanya Walsh and Steven Ward",
year = "2010",
month = "3",
doi = "10.1179/14653121042831",
language = "English",
volume = "37",
pages = "6--15",
journal = "Journal of Orthodontics",
issn = "1465-3125",
publisher = "Maney Publishing",
number = "1",

}

TY - JOUR

T1 - Juvenile idiopathic arthritis (JIA)

T2 - a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids

AU - Mandall, Nicky A.

AU - Gray, Robin

AU - O'Brien, Kevin D.

AU - Baildam, Eileen

AU - MacFarlane, Tatiana

AU - Davidson, Joyce

AU - Sills, John

AU - Foster, Helen

AU - Gardner-Medwin, Janet

AU - Garrahy, Ann

AU - Millett, Declan

AU - Mattick, Rye

AU - Walsh, Tanya

AU - Ward, Steven

PY - 2010/3

Y1 - 2010/3

N2 - Objective: To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids. Design: Cross-sectional screening. Subjects and setting: Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK. Method: Patients were screened clinically and radiographically for the presence of class II skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded. Main outcome measures: Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids. Results: The mean ANB values were 4·2 degrees (SD¿=¿2·9 degrees) in the oligoarticular group and 5·1 degrees (SD¿=¿3·8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20%), except for crepitus and click which affected between 24 and 40% of JIA children. Radiographically, 57% of oligoarticular and 77% of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P¿=¿0·001). Conclusions: Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.

AB - Objective: To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids. Design: Cross-sectional screening. Subjects and setting: Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK. Method: Patients were screened clinically and radiographically for the presence of class II skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded. Main outcome measures: Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids. Results: The mean ANB values were 4·2 degrees (SD¿=¿2·9 degrees) in the oligoarticular group and 5·1 degrees (SD¿=¿3·8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20%), except for crepitus and click which affected between 24 and 40% of JIA children. Radiographically, 57% of oligoarticular and 77% of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P¿=¿0·001). Conclusions: Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.

KW - juvenile idiopathic arthritis

KW - class II skeletal pattern

KW - temporomandibular joint signs and symptoms

KW - corticosteroid treatment

U2 - 10.1179/14653121042831

DO - 10.1179/14653121042831

M3 - Article

VL - 37

SP - 6

EP - 15

JO - Journal of Orthodontics

JF - Journal of Orthodontics

SN - 1465-3125

IS - 1

ER -