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Management of the temporomandibular joint in rheumatoid disorders

  • A.J. Sidebottom
    Correspondence
    Corresponding author. Tel.: +44 115 9249924x65895; fax: +44 115 8493386.
    Affiliations
    Maxillofacial Unit, Queens Medical Centre, Nottingham University Hospital, Derby Road, Nottingham NG7 2UH, United Kingdom
    Search for articles by this author
  • R. Salha
    Affiliations
    Maxillofacial Unit, Queens Medical Centre, Nottingham University Hospital, Derby Road, Nottingham NG7 2UH, United Kingdom
    Search for articles by this author

      Abstract

      This article summarises the rheumatoid diseases that particularly affect the temporomandibular joint (TMJ): psoriatic arthropathy, ankylosing spondylitis, and rheumatoid arthritis. Management is by a joint approach between rheumatologists and maxillofacial surgeons with a specific interest in diseases of the TMJ who give early surgical advice. Steroid injections, whilst useful in the short term, are not useful for long term or repeated treatment, and may lead to collapse of the joint and development of a deformed anterior open bite. These disorders should be managed primarily using standard conservative regimens, and failure to respond should lead to diagnostic or therapeutic arthroscopy and appropriate surgical treatment. When ankylosis develops or the joint collapses, a replacement joint should be considered and patients should be referred to an appropriately trained surgeon.

      Keywords

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