Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis
- PDF / 624,930 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 9 Downloads / 194 Views
RESEARCH ARTICLE
Open Access
Prosthetic temporomandibular joint reconstruction in a cohort of adolescent females with juvenile idiopathic arthritis Michael Lypka1,2*, Karina Shah2 and Jordan Jones2,3
Abstract Background: Temporomandibular joint (TMJ) arthritis and involvement is commonly seen in Juvenile Idiopathic Arthritis (JIA). Therapy includes conservative measures, but also includes intraarticular corticosteroid injections (IASI) and systemic immunosuppressive therapy. Despite aggressive medical therapy, some patients develop arthritic changes and frank TMJ ankylosis that can result in persistent pain and limitation in range of motion (ROM). A surgical option is prosthetic TMJ replacement with concurrent correction of dentofacial deformities, which can be performed simultaneously. The objective of this study was to evaluate the outcomes of prosthetic TMJ replacement in a cohort of adolescent females with JIA and severe TMJ involvement. Methods: This is a retrospective case series that took place at one tertiary care center. Patients with a diagnosis of JIA who also underwent alloplastic TMJ replacement were identified through electronic medical record system (EMR) and reviewed. Chart review included analysis of all documents in the EMR, including demographic data, JIA history, surgical complications, ROM of TMJ measured by maximal incisal opening in millimeters (mm) and TMJ pain scores (4-point Likert scale: none, mild, moderate, severe) obtained pre- and postoperatively. Results: Five female patients, ages 15–17 year when TMJ replacement was performed, had nine total joints replaced with a post-operative follow-up period of 12–30 months. All patients had polyarticular, seronegative JIA and were treated with IASI and multiple immunosuppressive therapies without resolution of TMJ symptoms. One patient had bilateral TMJ ankylosis. Three of the five patients demonstrated significant dentofacial deformities, and all underwent simultaneous or staged orthognathic surgery. All patients had improvement in TMJ pain with most (80%) reporting no pain, and all had similar or improved ROM of their TMJ postoperatively. There was one delayed postoperative infection with Cutibacterium Acnes that presented 15 months after surgery and required removal and reimplantation of prosthesis. (Continued on next page)
* Correspondence: [email protected] 1 Division of Plastic and Craniofacial Surgery, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA 2 University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or ot
Data Loading...
