406 Juvenile chronic arthritis (JCA) is defined as chronic arthritis in childhood with an onset before the age of 16 years and a duration of more than 3 months (European League Against Rheumatism criteria). 1,2 The European terminology JCA differs from that used in North America (ie, juvenile rheumatoid arthritis, or JRA), primarily with respect to the disease duration before the diagnosis can be made: In JCA, it is 3 months and in JRA, 6 weeks. In addition, juvenile ankylosing spondylitis, arthropathies with inflammatory bowel disease, and juvenile psoriatic arthropathy are included in a diagnosis of JCA, but not in JRA. The prevalence of JCA is estimated to range between 60 and 80 per 100,000 people. Girls are more frequently affected than boys. 3 The etiology is unclear, but heredity is considered an important risk factor, and infections may precipitate the disease. According to the expression at onset and during the first 6 months of the disease, JCA is classified as (1) pauciarticular (maximum of 4 involved joints), which is the most common; (2) polyarticular (5 or more involved joints); or (3) as the rare systemic type (Still’s disease). 1,2 The course of the disease may be progres- sive and may change from one subtype to another (eg, from pauciarticular to polyarticular, so-called extended pauciarticular). Estimation of the prognosis is difficult because in some cases the disease may lead to severe disability and/or persist into adulthood, whereas in others it goes into full remission without residua. The characteristic manifestations are chronic synovitis, arthralgia, and impaired joint mobility. In some cases, erosive disease may develop, with destruc- tion of cartilage and subchondral bone. The knee joints and the joints of the feet and hands are frequently involved. High frequencies (38%-72%) of most often bilateral temporomandibular joint (TMJ) involvement have previously been reported, 4-8 and associations were found with early onset, long disease duration, and polyarticular course of the disease. 6,9 As a result of the condylar destruction and growth disturbances, patients with JCA may have retrognathia and micrognathia, with shortening of the rami of the mandible and anterior bite opening (Bjork and Skieller 10 and Kjellberg 11 ). Orofacial pain, jaw function, and temporomandibular disorders in women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis Merete Bakke, DDS, PhD, Dr Odont, a Marek Zak, MD, b Birgit Leth Jensen, DDS, PhD, Dr Odont, c Freddy Karup Pedersen, MD, b and Sven Kreiborg, DDS, PhD, Dr Odont, d Copenhagen, Denmark UNIVERSITY OF COPENHAGEN AND RIGSHOSPITALET Objectives. We sought to study the long-term outcome of juvenile chronic arthritis (JCA) in the temporomandibular joint (TMJ). Study design. Temporomandibular disorders, including TMJ involvement, were assessed in 42 women with pauciarticular or polyarticular JCA—on average 25.8 years from disease onset—and compared with those found in matched control subjects. Disease-related parameters associated with temporomandibular disorders were identified. Results. The TMJ was involved in 66.7% of the patients, most severely in extended pauciarticular JCA. Temporomandibular disorders were more frequent in the patients than in the control subjects, especially in those with persistent disease. The TMJ involvement was positively correlated with disease duration and negatively correlated with jaw opening and occlusal support. Duration of active JCA and history of functional pain were identified as predictors of present TMJ involvement. Conclusion. In a long-term follow-up, TMJ involvement proved frequent in the studied patients and was associated with long disease duration and previous pain on jaw opening. The findings suggest that patients with JCA should undergo orofacial eval- uation on a regular basis. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:406-14) Supported by The Danish Rheumatism Association, The Danish Hospital Foundation for Medical Research, the Region of Copenhagen, The Faroe Islands and Greenland, The Gangsted Foundation, and The Rosalie Petersen Foundation. a Department of Oral Function and Physiology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen. b University Clinic of Pediatrics II, Rigshospitalet. c Departments of Pedodontics and Oral Function and Physiology, School of Dentistry, University of Copenhagen. d Department of Pedodontics, School of Dentistry, University of Copenhagen, and University Clinic of Pediatrics I, Rigshospitalet. Received for publication Oct 19, 2000; returned for revision Jan 17, 2001; accepted for publication Feb 8, 2001. Copyright © 2001 by Mosby, Inc. 1079-2104/2001/$35.00 + 0 7/13/115467 doi:10.1067/moe.2001.115467