Jaw surgery for correction of dentofacial anomalies caused by JIA

Nørholt, Sven Erik; Bjørnland, Tore; Pedersen, Thomas Klit

doi:10.1053/j.sodo.2015.02.011

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Once a child has reached skeletal maturity, surgery is the only means of correcting anatomic abnormalities. The consensus is that surgery is not optimally performed in clinically active TMJs, and is generally postponed until growth is complete [ 78 ]. However, if TMJ ankyloses develops, surgical intervention such as arthroplasty, or total prosthetic joint replacement is indicated sooner.…”

Section: Methodsmentioning

confidence: 99%

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Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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BackgroundArthritis involving the temporomandibular joint (TMJ) complicates 40 - 96% of cases of juvenile idiopathic arthritis (JIA), potentially leading to devastating changes to form and function. Optimal evaluation and management of this joint remains a matter of ongoing discussion.MethodsWe performed a PubMed search for all articles with keywords “temporomandibular” and “arthritis”, covering the dates 2002 through February 28, 2018. A separate PubMed search was performed for all articles with keywords “temporomandibular joint”, “arthritis”, and “treatment” covering the same dates.FindingsThe TMJ is a particularly challenging joint to assess, both clinically and with imaging studies. Clinical assessment of the TMJ is hampered by the low sensitivity of joint pain as well as the absence of physical exam findings early in the disease process. As with all joints, plain radiography and computed tomography only detect arthritic sequelae. Additionally, there is mixed data on the sensitivity of ultrasound, leaving magnetic resonance imaging (MRI) as the optimal diagnostic modality. However, several recent studies have shown that non-arthritic children can have subtle findings on MRI consistent with TMJ arthritis, such as joint effusion and contrast enhancement. Consequently, there has been an intense effort to identify features that can be used to differentiate mild TMJ arthritis from normal TMJs, such as the ratio of the enhancement within the TMJ itself compared to the enhancement in surrounding musculature. With respect to treatment of TMJ arthritis, there is minimal prospective data on medical therapy of this complicated joint. Retrospective studies have suggested that the response to medical therapy of the TMJ may lag behind that of other joints, prompting use of intraarticular (IA) therapy. Although most studies have shown short-term effectiveness of corticosteroids, the long-term safety of this therapy on local growth as well as on the development of IA heterotopic bone have prompted recommendations to limit use of IA corticosteroids. Severe TMJ disease from JIA can also be managed non-operatively with splints in a growing child, as well as with surgery.ConclusionIn this review, we summarize literature on the diagnosis and management of TMJ arthritis in JIA and suggest a diagnostic and therapeutic algorithm for children with refractory TMJ arthritis.

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Section: Methodsmentioning

confidence: 99%

“…However, if TMJ ankyloses develops, surgical intervention such as arthroplasty, or total prosthetic joint replacement is indicated sooner. Surgical options were reviewed in depth by Norholt et al [ 78 ]. Briefly, two options are available: distraction osteogenesis and orthognathic surgery.…”

Section: Methodsmentioning

confidence: 99%