Temporomandibular Joint Acoustic Emissions in Children With Juvenile Idiopathic Arthritis Differ From Those in Healthy Children

Daniel C Whittingslow; Talia Gergely; Sampath Prahalad; Omer T Inan; Shelly Abramowicz

doi:10.1016/j.joms.2022.05.009

Temporomandibular Joint Acoustic Emissions in Children With Juvenile Idiopathic Arthritis Differ From Those in Healthy Children

J Oral Maxillofac Surg. 2022 Sep;80(9):1466-1473. doi: 10.1016/j.joms.2022.05.009. Epub 2022 Jun 7.

Authors

Daniel C Whittingslow¹, Talia Gergely², Sampath Prahalad³, Omer T Inan⁴, Shelly Abramowicz⁵

Affiliations

¹ MD/PhD Student, Emory University School of Medicine and Georgia Institute of Technology, Coulter Department of Biomedical Engineering, Atlanta, GA.
² Medical Student, Rocky Vista University, College of Osteopathic Medicine, Research Coordinator at Emory University, Denver, CO.
³ Marcus Professor of Pediatric Rheumatology and Chief of the Division of Pediatric Rheumatology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA.
⁴ Linda J. and Mark C. Smith Chair in Bioscience and Bioengineering and Associate Professor, School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA.
⁵ Associate Professor of Surgery, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Chief, Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA. Electronic address: sabram5@emory.edu.

PMID: 35724734
DOI: 10.1016/j.joms.2022.05.009

Abstract

Purpose: Articulation of the temporomandibular joint (TMJ) generates sounds with specific characteristics known as joint acoustic emissions (AEs). The purpose of this project was to determine if AEs as described by the joint health score (JHS) in children with juvenile idiopathic arthritis (JIA) differ from AEs in healthy children.

Methods: The investigators implemented a cross-sectional study with age- and sex-matched controls to compare AEs from 4 groups: (1) healthy subjects without TMJ sounds, (2) healthy subjects with TMJ sounds, (3) subjects with JIA without TMJ sounds, and (4) subjects with TMJ sounds. Predictor variables were JIA status (ie JIA/healthy) and joint sounds (present/absent). The outcome variable was AEs. Subjects wore a specialized headset and performed specific jaw movements that generated AEs. AEs were recorded and analyzed using an aggregated decision tree classification model that calculates a JHS for each group. JHSs were compared using a receiver operating characteristic curve and classification accuracies. The study team used a 2-tailed unpaired t-test to determine if score distributions were different. Significance was P < .05.

Results: A total of 51 subjects (102 TMJs; 37 females) with an average age of 13.1 years (range, 7 to 18) participated. Children with JIA and TMJ sounds had AEs with large repetitive clicks. Children with JIA without sounds had smaller repetitive clicks. Healthy children had grinding sounds with lower amplitude. The receiver operating characteristic curve had a classification accuracy of 71.6%. This accuracy compares against the gold standard clinical assessment for placing these patients into their groups (JIA vs healthy). JHSs of children with TMJ sounds and children with JIA and TMJ sounds were statistically significant (P < .0001).

Conclusion: In our sample, the AE of TMJs in healthy children may be different than that in children with JIA. Assessment of an AE is a promising and noninvasive technique to determine involvement of TMJs in children with JIA.

MeSH terms

Acoustics
Adolescent
Arthritis, Juvenile*
Child
Cross-Sectional Studies
Female
Humans
Magnetic Resonance Imaging
Temporomandibular Joint
Temporomandibular Joint Disorders*