Osteoarhritis of Temporomandibular Joint in Children and Adolescents Compared with Adult Patient Population - EAP 2017 Congress and MasterCourse, October 12-15, 2017, Ljubljana, Slovenia

Tomislav Badel ¹ Ivana Savić Pavičin ² Nenad Lukić ³ Jelena Valpotić ⁴ Dijana Zadravec ⁵

¹Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb
²Department of Dental Anthropology, School of Dental Medicine, University of Zagreb
³Clinic of Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center of Dental Medicin, University of Zurich
⁴Department of Paediatric and Preventive Dentistry, Outpatient Dental Clinic “Zagreb”
⁵Department of Diagnostic and Interventional Radiology, Clinical Hospital Center “Sestre milosrdnice”, University of Zagreb

Background: Osteoarthritis (OA) is a low-inflammatory arthritic condition that results in various degenerative joint changes clinically manifested as crepitation and arthralgia of the temporomandibular joint (TMJ) with limited opening of the mouth.

Objective: The aim of this study was to compare clinical characteristics of children and adolescents in the sample of general patient population with OA of TMJ.

Methods: A prospective study was carried out between January 2001 and December 2015 and it included 174 patients with OA of TMJ. The sample of patients was divided in two groups: 6 patients aged under 20 (mean age of 17.7) and the remaining 168 patients (mean age of 50.2) who were seeking treatment. Pain intensity (at first examination T0) in TMJ was shown on the visual-analogue scale (VAS; 0, no pain; 10, the most severe pain). They were treated by an occlusal splint and/or physical therapy with a six-month (T1) and one-year (T2) follow-up. Definitive TMJ-diagnoses were confirmed by magnetic resonance imaging (MRI).

Results: There was no statistical difference between average pain at T0 in patients over 20 (6.2) and patients aged up to 19 (6.4) evaluated by VAS (p>0.05). In the beginning, the pain by VAS amounted to T1 in patients aged up to 19 on 1.5 and in patients over 20 on 2.5 (p<0.05) and at T2 patients aged up to 19 had no pain (0) and for patients aged over 20, the pain was 1.7 (p<0.001). MRI findings for patients aged up to 19 were: predominately erosions of the condylar head and anterior disc displacement without reduction in all patients.

Conclusions: OA was rarely observed in very young TMJ patients and MR images showed no osteophyte formation on TMJs. However, the prognosis of TMJ treatment is better for young patients compared to that for the older ones.