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. 2021 Jul;48(7):774-784.
doi: 10.1111/joor.13172. Epub 2021 May 4.

Maximum bite force in children with juvenile idiopathic arthritis with and without clinical established temporomandibular joint involvement and in healthy children: a cross-sectional study

Willemijn F C de Sonnaville  1 , Caroline M Speksnijder  1 , Nicolaas P A Zuithoff  2 , Daan R C Verkouteren  1 , Nico W Wulffraat  3 , Michel H Steenks  1 , Antoine J W P Rosenberg  1
Affiliations

Maximum bite force in children with juvenile idiopathic arthritis with and without clinical established temporomandibular joint involvement and in healthy children: a cross-sectional study

Willemijn F C de Sonnaville et al. J Oral Rehabil. 2021 Jul.

Abstract

Background: In children with juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) can be involved, resulting in dysfunction of the masticatory system. Bite force is one of the variables that reflects the function of the masticatory system. The aim of this study was to compare maximum bite force in children with JIA, with and without TMJ involvement and with healthy children.

Methods: Children with JIA and healthy children between the ages 6 and 18 were included in this cross-sectional study. The clinical examination consisted of measuring the anterior maximum voluntary bite force (AMVBF), assessment of the TMJ screening protocol items and TMJ, masseter and temporal muscle palpation pain. Unadjusted linear regression analyses were performed to evaluate the explanatory factors for AMVBF. Two adjusted models were constructed with corrections for age and gender differences: model 1 to compare children with JIA and healthy children and model 2 to compare children with JIA with and without TMJ involvement.

Results: In this cross-sectional study, 298 children with JIA and 169 healthy children participated. AMVBF was 24 Newton (N) lower in children with JIA, when compared with healthy children (95%CI: -35.5--12.4, p = .000). When children with JIA also had clinically established TMJ involvement, AMVBF was reduced 42 N (component JIA:-16.78, 95% CI -28.96--4.59, p = .007 and component TMJ involvement:-25.36, 95% CI -40.08--10.63, p = .001). Age and male gender increased AMVBF.

Conclusion: Children with JIA had a reduction in the AMVBF compared with healthy children. In children with JIA and clinically established TMJ involvement, AMVBF was more reduced.

Keywords: arthritis; bite force; child; cross-sectional studies; juvenile; linear models; temporomandibular joint.

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Conflict of interest statement

The authors report no financial conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Estimated marginal means anterior voluntary maximum bite force in children with JIA and in healthy children. The estimated marginal means of anterior voluntary maximum bite force (AMVBF) are subtracted from the linear regression model 1 (Table 3). The AMVBF in Newton (N) for each year group is presented
FIGURE 2
FIGURE 2
Estimated marginal means anterior voluntary maximum bite force in children with JIA, with and without TMJ involvement and in healthy children. The estimated marginal means of anterior voluntary maximum bite force (AMVBF) are subtracted from the linear regression model 2 (Table 3). The AMVBF in Newton (N) for each year group is presented
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