| Intra-Articular Corticosteroid Injections to the Temporomandibular Joints Are Safe and Appear to Be Effective Therapy in Children With Juvenile Idiopathic Arthritis. | |
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MedLine Citation:
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PMID: 22265164 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this study was to evaluate the safety and efficacy of intra-articular corticosteroid injections (IACIs) of the temporomandibular joint (TMJ) in children with juvenile idiopathic arthritis (JIA) when administered by an oral and maxillofacial surgeon without imaging guidance. MATERIALS AND METHODS: This was a retrospective study of children with JIA, seen at a single center, who were selected based on having received IACIs of the TMJ. All subjects received the intervention, which consisted of referral to a single oral and maxillofacial surgeon for TMJ IACI with 5 to 10 mg triamcinolone hexacetonide, under general anesthesia. Primary outcomes assessed in all subjects were the safety of the procedure and efficacy as determined by the change in maximal incisal opening (MIO). In addition, a subset of 31 subjects underwent repeat magnetic resonance imaging of the TMJ, permitting analysis of the change in the acute and chronic findings of arthritis in those patients. RESULTS: Sixty-three patients (68% female) received 137 IACIs. The mean age for diagnosis of JIA was 8.5 years, and the mean age at presentation for TMJ injections was 10 years. The injections were well tolerated: only 1 patient developed the steroid complication of hypopigmentation, and none developed degeneration or ankylosis. In terms of efficacy, the mean MIO increased from 40.8 ± 0.93 to 43.5 ± 0.90 mm (P = .001); in addition, changing the unit of analysis to individual joints, in patients who underwent repeat magnetic resonance imaging examination, 51% of TMJs showed magnetic resonance imaging evidence of improvement of arthritic changes, of whom 18% had complete resolution of TMJ arthritis. CONCLUSIONS: The results indicate that IACI of the TMJ can be safely performed by experienced oral and maxillofacial surgeons without a requirement for computed tomographic guidance. In addition, these results show that IACI may be effective in the management of TMJ arthritis, although further studies are required. |
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Authors:
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Matthew L Stoll; Jennifer Good; Tyler Sharpe; Timothy Beukelman; Daniel Young; Peter D Waite; Randy Q Cron |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-19 |
Journal Detail:
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Title: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons Volume: - ISSN: 1531-5053 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8206428 Medline TA: J Oral Maxillofac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Assistant Professor, Department of Pediatrics, Division of Rheumatology, Children's Hospital of Alabama, Birmingham, AL. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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