Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease of childhood. JIA can affect any joint and the temporomandibular joint (TMJ) is one of the joints most frequently involved. TMJ arthritis impacts mandibular growth and development and can result in skeletal deformity (convex profile and facial asymmetry), and malocclusion. Furthermore, when TMJs are affected, patients may present with pain at joint and masticatory muscles and dysfunction with crepitus and limited jaw. This session aims to evaluate the role of orthodontists in the management of patients with JIA and TMJ involvement by discussing the evidence for the diagnosis and treatment of patients with JIA and TMJ involvement. Screening for the orofacial manifestation of JIA is important for orthodontists to identify TMJ involvement and related dentofacial deformity. The treatment protocol of JIA with TMJ involvement requires an interdisciplinary collaboration including orthopaedic/ orthodontic treatment and surgical interventions for the management of growth disturbances. Orthodontists are also involved in the management of orofacial signs and symptoms; behavioral therapy, physiotherapy and occlusal splints are the suggested treatments movement. Patients with TMJ arthritis require specific expertise from an interdisciplinary team with members knowledgeable in JIA care. Since disorders of mandibular growth often appear during childhood, the orthodontist could be the first clinician to see the patient and can play a crucial role in the diagnosis and management of JIA patients with TMJ involvement.
Learning Objectives:
After this session, attendees will be able to:
Detect children affected by TMJ-JIA and make the differential diagnosis of TMJ-JIA versus other TMJ pathologies.
Perform clinical examinations to detect signs and symptoms of TMJ-JIA which include pain, dysfunction and alteration in the growing pattern.
Discuss the management of patients affected by TMJ-JIA.
