Comparing clinical and radiological manifestations of adolescent idiopathic condylar resorption and juvenile idiopathic arthritis in the temporomandibular joint

Abstract Objective This cross-sectional study compared orofacial manifestations at the time of diagnosis in 2 temporomandibular joint (TMJ) conditions: adolescent idiopathic condylar resorption (ICR) and TMJ involvement from juvenile idiopathic arthritis (JIA). Material and methods This retrospective study included 19 JIA, 19 ICR and 19 control patients, all treated at the Section of Orthodontics, Aarhus University Craniofacial Clinic, Denmark. From patient files, we retrieved radiological data from cone-beam computed tomographies (CBCT) along with information on symptoms and orofacial function at the time of diagnosis. Validated methodologies were used to evaluate TMJ and dentofacial morphology. Results We found no statistically significant inter-group differences in severity of deformation of TMJ structures (TMJ deformity) between JIA and ICR patients. However, the ICR group showed significantly greater signs of dentofacial deformity on 4 outcome variables; mandibular inclination, posterior/anterior lower face height ratio, mandibular sagittal position and mandibular occlusal plane inclination. Significant inter-group differences in clinical presentation were seen in 5 out of 20 variables. Thus, the JIA group reported significantly more symptoms of TMJ pain, TMJ morning stiffness and TMJ pain on palpation during the clinical examination, whereas the ICR group reported significantly more TMJ clicking during function and had a higher proportion of patients with anterior open bite. Conclusion CBCT examination showed a similar degree of TMJ deformity in ICR and JIA patients at the time of diagnosis. ICR patients presented with a significantly higher degree of dentofacial deformity than JIA patients and healthy controls, which relates to the timing of the diagnosis. Arthralgia, TMJ morning stiffness and TMJ palpitation pain were more common in JIA patients, whereas TMJ clicking during function and anterior open bites were more common in ICR patients.