Desordem temporomandibular em pacientes com artrite idiopática juvenil: avaliação clínica e correlação com os achados de tomografia computadorizada de feixe cônico

Abstract

Temporomandibular disorders (TMD) are alterations triggered by joint and/or muscle disorders in the orofacial region characterized by expressing pain or dysfunction. Juvenile idiopathic arthritis (JIA) is a chronic and systemic disease, which begins in children and adolescents under 16 years old and is characterized by a chronic synovitis in the joints. The objectives of this research were to evaluate the presence of TMD in patients with JIA using Research Diagnostic Criteria to Temporomandibular Disorders (RDC/TMD), and subsequently to correlate the clinical diagnosis of TMD with the findings of Cone Beam Computed Tomography (CBCT) and with the age, gender, time of symptoms onset, treatment time and subtype of JIA patients. Fifteen patients (eight male and seven females) aged between six and 28 years (mean age of 16.3 years) we evaluated. Twenty-five (83.3%) temporomandibular joints (TMJ) had clinical diagnosis of TMD. Despite joint alterations have been frequent in the evaluation by CBCT (83.3%), only five (17.7%) ATM had a clinical diagnosis of osteoarthritis or osteoarthrosis. After statistical analysis of the results, with significance level of 5% (p ≤ 0.05), it was suggested that: clinical diagnosis of TMD and the findings of TCFC had no statistically significant correlation with gender and subtype of JIA; a greater number of clinical diagnoses of TMD on the right-hand side increased the probability of finding a greater degree of TMD on the lef-hand side, and the longer the time from symptom onset JIA, the greater the degree of TMD and the probability of finding tomographic alterations on both sides; a greater number of tomographic alterations on the right-hand side increased the probability of finding a greater alteration degree on the left-hand side tomographic; the ATM on the left-hand side of patients affected by JIA at a later age, having the symptoms onset beginning longer ago and a longer duration of treatment were related to a greater degree of tomographic alterations; when the JIA symptoms onset began more than three years ago, the greater was the degree of TMD (righthand and left-hand side) and the degree of tomographic alteration (left side), also was greater the probability of finding TMD diagnosis and tomographic alterations on both sides; when the patients are older than 16 by the time of the evaluation, the greater the degree of TMD and alterations found tomographic (left-hand side).