Bedømmelseskomité
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Professor Mohamed E. Parker, University of the Western Cape
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Dr. Marinka Twilt, Sophia Children 's Hospital
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Førsteamanuensis Kari Birkeland, UiO
Leder av disputas
Tid og sted for prøveforelesning
2.desember, klokken 14.15 - Geitmyrsveien 69 - auditorium 1
Veiledere
- Tore A. Larheim, Institutt for klinisk odontologi
- Berit Flatø, Oslo Universitetssykehus
- Hans-Jørgen Smith, Oslo Universitetssykehus
- Bjørn Øgaard, Institutt for klinisk odontologi
For mer informasjon kontakt Knut Gythfeldt
Sammendrag
Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease in children and adolescents below 16 years of age. This heterogeneous disease is characterized by joint inflammation and may also involve other organs. Although often overlooked the temporomandibular joint (TMJ) may be involved, causing craniofacial growth disturbances. The frequency of TMJ involvement varies greatly in the literature depending on the diagnostic methods and the patient groups studied. There are very few longitudinal studies and none for longer than 6 years. By studying patients from childhood to adulthood, the aim was to assess the frequency and the nature of TMJ abnormalities and to relate these findings to craniofacial growth. From an original group of 103 JIA patients examined as children, 60 adult patients participated in a follow-up study approximately 27 years after baseline. Clinical and imaging examinations of the craniofacial region including CT and MRI of the TMJs were performed. Longitudinal radiological examinations were compared to similar examinations of healthy controls. The frequency of TMJ involvement and bilateral findings was found to increase over time. In adult age about ¾ of the patients had TMJ involvement and in 42% of those mild synovitis was observed. The joints showed a great variety of deformations and in 70% of the patients with TMJ findings craniofacial growth disturbances were observed. More surprisingly, despite severe TMJ involvement in childhood, some patients were found to have developed a normal facial profile. Most patients showed progressive TMJ abnormalities, but in a few patients with improvement, a more normal craniofacial growth was observed. Early diagnosis of TMJ arthritis seems important since there is a potential to regain growth towards normalcy if the disease is suppressed.