Time to Reconsider Management of the Temporomandibular Joint in Juvenile Idiopathic Arthritis

Cory M Resnick; Thomas K Pedersen; Shelly Abramowicz; Marinka Twilt; Peter B Stoustrup

doi:10.1016/j.joms.2018.02.019

Time to Reconsider Management of the Temporomandibular Joint in Juvenile Idiopathic Arthritis

J Oral Maxillofac Surg. 2018 Jun;76(6):1145-1146. doi: 10.1016/j.joms.2018.02.019. Epub 2018 Feb 26.

Authors

Cory M Resnick¹, Thomas K Pedersen², Shelly Abramowicz³, Marinka Twilt⁴, Peter B Stoustrup⁵

Affiliations

¹ Assistant Professor, Harvard School of Dental Medicine and Harvard Medical School, Boston; Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA. Electronic address: cory.resnick@childrens.harvard.edu.
² Professor, Section of Orthodontics, Department of Odontology and Oral Health, Aarhus University, Aarhus; Consultant Orthodontist, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
³ Associate Professor, Emory University School of Medicine, Atlanta; Oral and Maxillofacial Surgeon, Departments of Surgery and Pediatrics, Division of Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA.
⁴ Assistant Professor, University of Calgary, Calgary; Pediatric Rheumatologist, Division of Rheumatology, Department of Paediatrics, Alberta Children's Hospital, Calgary, AB, Canada.
⁵ Associate Professor, Section of Orthodontics, Department of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.

PMID: 29567437
DOI: 10.1016/j.joms.2018.02.019

Abstract

The temporomandibular joints are often affected by juvenile idiopathic arthritis, but few evidence-based management strategies exist. Intra-articular steroid injection (IASI) is a common intervention and is associated with pain reduction and improved mandibular function. Emerging evidence, however, suggests that IASI may actually impair rather than improve mandibular growth. It is therefore time to reconsider this practice.

MeSH terms

Arthritis, Juvenile / complications*
Child
Glucocorticoids / administration & dosage
Glucocorticoids / adverse effects*
Humans
Injections, Intra-Articular / adverse effects*
Mandible / drug effects*
Mandible / growth & development*
Temporomandibular Joint Disorders / drug therapy*
Temporomandibular Joint Disorders / etiology*

Substances

Glucocorticoids