Heterotopic Ossification of the Temporomandibular Joint in Juvenile Idiopathic Arthritis

Abstract

Heterotopic ossifications of the TMJ may be seen in children with JIA and are associated with particularly severe TMJ arthritis, joint destruction, and pannus formation. Pathology from these joints suggests that the heterotopic ossification may result from multiple pathological processes.

Role of Corticosteroids in Oral Lesions

“…In recent studies of juvenile idiopathic arthritis, intra-articular corticosteroid (triamcinolone) injections improved or even completely eliminated TMJ pain in 77-88% of children for several months (Arabshahi 2005;Cahill 2007;Ringold 2008).…”

The Role of Corticosteroids in Today's Oral and Maxillofacial Surgery

“…[14] Other studies also confirmed that corticosteroid injection of the TMJ can be safely performed in children with JIA, and is effective. [15][16][17][18] Few studies have evaluated TMJ corticosteroid injection in JIA. In these studies the volume of corticosteroid injected was chosen empirically.…”

Silent Joint in Dispute. Is Intraarticular Treatment of Temporomandibular Joint Questionable?

“…In general, studies have reported on symptomatic relief after IACS injection in the TMJ, including reduced pain and changes in the physical examination findings of maximal incisal opening 7,8,12 . Two of these studies reported magnetic resonance imaging (MRI) changes with improved effusion in 67% 8 and reduced inflammation in the TMJ in 39% 12 after IACS.…”

“…Locally administered therapy, typically in the form of intraarticular corticosteroids (IACS) in the TMJ, has been a frequent strategy in the management of children with JIA within the last 10 years 7,8,9,10,11,12 . In general, studies have reported on symptomatic relief after IACS injection in the TMJ, including reduced pain and changes in the physical examination findings of maximal incisal opening 7,8,12 .…”