Temporomandibular Joint- The neglected joint of children with Juvenile Idiopathic Arthritis

Background: Juvenile Idiopathic Arthritis-JIA is the most common inflammatory rheumatic disease during childhood, and affects Temporomandibular Joint-TMJ among other joints. TMJ arthritis can proceed without clinical signs and symptoms and remain undiagnosed, with detrimental effects on child's normal craniofacial growth and mandibular development. Aim: This review summarizes the current developments and contemporary literature on TMJ arthritis in patients with JIA and aims to provide the highest level of evidence on the subject. Design: MEDLINE and Web of Science databases were searched using related keywords. From the selected abstracts, non-English and in vivo studies were excluded, while from the rest full-text was obtained for further analysis. Results: The most common clinical finding in children with TMJ involvement is limited mouth opening, while deviation during opening and pain during chewing are also present. Furthermore, an analysis of the pathogenesis of JIA, the imaging techniques, the pattern of craniofacial development, as well as the treatment management is presented, along with a screening protocol for the assessment of TMJ for an early diagnosis. Conclusion: It is of utmost importance for the attending paediatrician and paediatric dentist to monitor TMJ function periodically, due to its impact in craniofacial development.