Paediatric Rheumatology
High prevalence of orofacial pain in juvenile fibromyalgia as detected by a novel tool specifically devised for children and adolescents
C. Malattia1, G. Chiappe2, C. Capurro3, M. Puntoni4, G. Cadeddu5, C. Lavarello6, A. Ravelli7, N. Laffi8
- Paediatric Rheumatology and Autoinflammatory Unit, IRCCS Istituto Giannina Gaslini, Genova, and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova, Italy. claramalattia@gaslini.org
- Paediatric Dentistry and Orthodontics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
- Paediatric Dentistry and Orthodontics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Italy.
- Paediatric Dentistry and Orthodontics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
- Paediatric Rheumatology and Autoinflammatory Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova, and Scientific Direction, IRCCS Istituto Giannina Gaslini, Genova, Italy.
- Paediatric Dentistry and Orthodontics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
CER17470
2024 Vol.42, N°6
PI 1272, PF 1279
Paediatric Rheumatology
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PMID: 38966943 [PubMed]
Received: 13/01/2024
Accepted : 03/04/2024
In Press: 04/07/2024
Published: 04/07/2024
Abstract
OBJECTIVES:
To examine the prevalence of temporomandibular disorders (TMD) in patients with juvenile fibromyalgia syndrome (JFS) and identify TMD characteristics specifically associated to JFS.
METHODS:
Signs and symptoms of TMD were assessed using a novel clinical tool specifically devised for children that consists of: 1. a self-report multiple-choice questionnaire; 2. a protocol for the clinical examination of the orofacial region. Multivariate logistic regression model was used to identify TMD features associated with JFS.
RESULTS:
Thirty JFS patients (median age 15.5 years) and 45 healthy controls (median age 15.0 years) were included in this cross-sectional study. Orofacial pain was reported by 26 of 30 JFS patients (86.7%) and by 3 of 45 controls (6.7%; p<0.001). Pain on TMJ palpation was present in 18 of 30 JFS patients (60%) and in 5 of 45 controls (11.1%; p<0.001). Median values of maximum spontaneous mouth opening, voluntary active opening and assisted passive opening were significantly higher in JFS patients than in controls. On multiple regression analysis spontaneous orofacial pain (OR: 21.0; p=0.005), diffuse tenderness on palpation of the masticatory muscles (OR: 14.9; p=0.026) and TMJ hypermobility (OR 1.42; p=0.008) were independently associated with JFS.
CONCLUSIONS:
The high prevalence of TMD in JFS highlights the need for a broader interdisciplinary evaluation of JFS patients. TMJ hypermobility, in addition to orofacial and masticatory muscle pain, is an important clue for the diagnosis of TMD in adolescents with JFS. Elucidating the link between these disorders will advance individualised management and improve treatment efficacy.