Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies

Peter Stoustrup; Marinka Twilt; Lynn Spiegel; Kasper Dahl Kristensen; Bernd Koos; Thomas Klit Pedersen; Annelise Küseler; Randy Q Cron; Shelly Abramowicz; Carlalberta Verna; Timo Peltomäki; Per Alstergren; Ross Petty; Sarah Ringold; Sven Erik Nørholt; Rotraud K Saurenmann; Troels Herlin; euroTMjoint Research Network

doi:10.3899/jrheum.160796

Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies

J Rheumatol. 2017 Mar;44(3):326-333. doi: 10.3899/jrheum.160796. Epub 2017 Jan 15.

Authors

Peter Stoustrup^{1

2}, Marinka Twilt^{3

4}, Lynn Spiegel^{3

4}, Kasper Dahl Kristensen^{3

4}, Bernd Koos^{3

4}, Thomas Klit Pedersen^{3

4}, Annelise Küseler^{3

4}, Randy Q Cron^{3

4}, Shelly Abramowicz^{3

4}, Carlalberta Verna^{3

4}, Timo Peltomäki^{3

4}, Per Alstergren^{3

4}, Ross Petty^{3

4}, Sarah Ringold^{3

4}, Sven Erik Nørholt^{3

4}, Rotraud K Saurenmann^{3

4}, Troels Herlin; euroTMjoint Research Network

Affiliations

¹ From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland. pstoustrup@odont.au.dk.
² P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University. pstoustrup@odont.au.dk.
³ From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.
⁴ P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University.

PMID: 28089967
DOI: 10.3899/jrheum.160796

Abstract

Objective: To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research.

Methods: Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations.

Results: Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies.

Conclusion: Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.

Keywords: JUVENILE IDIOPATHIC ARTHRITIS; OROFACIAL EXAMINATION; TEMPOROMANDIBULAR JOINT.

Publication types

Review
Systematic Review

MeSH terms

Arthritis, Juvenile / complications*
Arthritis, Juvenile / physiopathology
Humans
Physical Examination
Temporomandibular Joint Disorders / complications
Temporomandibular Joint Disorders / diagnosis*
Temporomandibular Joint Disorders / physiopathology