Evaluation of Changes in Oral-Health-Related Quality of Life Following Functional Therapy in Patients with Juvenile Idiopathic Arthritis

Objectives Temporomandibular (TMJ) is frequently involved during Juvenile idiopathic arthritis (JIA) which can cause cartilage and bone damage as well as global disability. Given the important role of TMJ involvement, there is an increasing interest in therapies that could improve the quality of life in JIA patients. The objectives of the present study were to evaluate the clinical effectiveness of functional therapy used to reduce TMJ disorder in patients with JIA and by improving the Oral-health-related quality of life (OHRQoL). Methods Forty-four patients with JIA (mean age, 12.9 ± 2.4 years) and with TMJ involvements was enrolled in the study. Each patient, following the collection of clinical parameters, was treated for 24 months with a functional therapy by the Andresen activator. TMJ sign and signs were recorded and OHRQoL was measured using the Oral Health Impact Profile (OHIP-14) questionnaire. The differences at baseline (T0) and after therapy (T1, 24 months) of the clinical TMJ signs and symptoms parameters were evaluated by the chi- squared test and the Friedman two-way Page 94 analysis of variance (ANOVA) was used to compare the relative changes in the OHRQoL scores. Results All patients successfully completed the study. The use of a functional appliance determined a statistically significant difference in the different OHIP-14 scores parameters (P< 0.001) and there were significant reductions in the domain of the OHIP-14 scores at T1, T2, and T3 compared with baseline (P< 0.001). Significant changes were observed in the maximal mouth opening, pain during jaw movement, TMJ sounds and crepitations (p<0.001) that were significantly reduced at T1 (p<0.05). Conclusions The results of this study suggest that functional therapy was safe and well tolerated by the patients and significantly improve OHRQoL and most probably reduces the level of TMJ inflammation and the TMJ arthritisrelated orofacial symptoms.