Please note: this is a repeat of the 3:00 p.m. session.
The temporomandibular joints (TMJs) are affected in the majority of patients with Juvenile Idiopathic Arthritis (JIA), the most common chronic pediatric rheumatologic condition. As a result of the unique anatomy of the TMJ, within which the primary growth center of the mandible is protected by only a thin layer of fibrocartilage, synovitis caused by JIA can elicit both osseous degeneration and cessation of mandibular growth. Morbidity ranges from minor malocclusion and/or facial asymmetry to pain, joint dysfunction, obstructive sleep apnea, facial disfigurement and decreased quality of life. No accepted management protocol exists.
Optimal management of TMJ disease from JIA requires multidisciplinary collaboration between oral and maxillofacial surgeons, rheumatologists, orthodontists, radiologists and other providers. While systemic medication therapy is the primary treatment modality for the systemic inflammatory disease, many patients will require orthopedic and/or surgical correction of the resulting dentofacial deformity. Options for management of dentofacial anomalies in children with JIA will be introduced.