Impact of temporomandibular joint arthritis on quality of life and daily functional disability in patients with juvenile idiopathic arthritis

AIM: Temporomandibular joint (TMJ) arthritis is a common consequence of the systemic disease in patients with juvenile idiopathic arthritis (JIA). Due to the involvement of TMJs, orofacial pain is a frequent finding during JIA and is reported to severely affect daily life of JIA patients. The objective of the study was to evaluate the impact of TMJ arthritis on the functional disability and quality of life in patients affected by JIA. Materials and Method: Sixty-two consecutive patients with JIA with or without TMJ arthritis and 35 healthy control subjects were enrolled in the study. The demographic data, disease activity and clinical characteristics were obtained from all patients. The functional disability was assessed using the Italian version of the Childhood Health Assessment Questionnaire (C-HAQ). The oral health-related quality of life (OHRQoL) was assessed using the Child Perception Questionnaire (CPQ11-14). Possible determining factors of TMJ arthritis comprised demographic, disease characteristics and scores derived from questionnaires that were assessed by a uni- and multivariable logistic regression analysis. Results: Compared with patients without TMJs arthritis, JIA patients with TMJ arthritis presented higher functional disability. The multivariable logistic regression analysis performed showed that female subjects (OR = 1.5, P = 0.041), with a JIA duration over 3.9 years (OR = 2.7, P = 0.033) and presenting higher C-HAQ and CPQ11-14 scores (OR = 2.7, P = 0.012 and OR = 2.9, P = 0.015, respectively) were the greatest determining factors for TMJ arthritis. Conclusions: JIA patients with TMJ arthritis presented higher functional disability and lower OHRQoL scores compared with JIA patients without TMJ arthritis. TMJ arthritis was strongly associated with JIA duration and activity, especially in female patients.