Peter Stoustrup1, Troels Herlin1, Lynn Spiegel1, Hanna Rahimi1, Bernd Koos1, Thomas Klit Pedersen1, Marinka Twilt. 1. From the Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, The Hospital of Sick Children, University of Toronto, Toronto, Ontario, Canada; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University, Denmark; Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.
Abstract
OBJECTIVE: To develop a consensus-based, standardized, short clinical (<3 minutes) examination protocol to assess the multidimensional, orofacial manifestations of juvenile idiopathic arthritis (JIA). METHODS: The study was conducted by a multidisciplinary task force from the Temporomandibular joint juvenile arthritis working (TMJaw) group. The study used an acknowledged sequential approach involving: 1) a global multidisciplinary online questionnaire study, 2) a systematic literature review and consensus-meetings to identify items for inclusion, 3) pilot-testing of included items, 4) test of reliability in 22 subjects with JIA by four examiners, 5) test of construct validity in a case-control study involving 167 subjects, 6) establishment of final recommendations. RESULTS: Six items were recommended for the final examination protocol: 1) clinician assessed pain location, 2) Temporomandibular joint pain on palpation (open and closed mouth), 3) Mandibular deviation at maximal mouth opening (≥3mm), 4) maximal unassisted mouth opening capacity, 5) frontal facial symmetry, 6) facial profile. All recommended items showed acceptable reliability and construct validity. The average mean examination time was two minutes and 42 seconds (SD ± 38.5 seconds). CONCLUSION: A consensus-based, short clinical examination protocol was developed. The protocol takes less than 3 minutes to complete and provides information about orofacial symptoms, temporomandibular joint dysfunction, and dentofacial deformity. The standardized examination protocol is applicable to routine clinical care as well as future research studies.
OBJECTIVE: To develop a consensus-based, standardized, short clinical (<3 minutes) examination protocol to assess the multidimensional, orofacial manifestations of juvenile idiopathic arthritis (JIA). METHODS: The study was conducted by a multidisciplinary task force from the Temporomandibular joint juvenile arthritis working (TMJaw) group. The study used an acknowledged sequential approach involving: 1) a global multidisciplinary online questionnaire study, 2) a systematic literature review and consensus-meetings to identify items for inclusion, 3) pilot-testing of included items, 4) test of reliability in 22 subjects with JIA by four examiners, 5) test of construct validity in a case-control study involving 167 subjects, 6) establishment of final recommendations. RESULTS: Six items were recommended for the final examination protocol: 1) clinician assessed pain location, 2) Temporomandibular joint pain on palpation (open and closed mouth), 3) Mandibular deviation at maximal mouth opening (≥3mm), 4) maximal unassisted mouth opening capacity, 5) frontal facial symmetry, 6) facial profile. All recommended items showed acceptable reliability and construct validity. The average mean examination time was two minutes and 42 seconds (SD ± 38.5 seconds). CONCLUSION: A consensus-based, short clinical examination protocol was developed. The protocol takes less than 3 minutes to complete and provides information about orofacial symptoms, temporomandibular joint dysfunction, and dentofacial deformity. The standardized examination protocol is applicable to routine clinical care as well as future research studies.
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