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Controversial Aspects of Diagnostics and Therapy of Arthritis of the Temporomandibular Joint in Rheumatoid and Juvenile Idiopathic Arthritis - An Analysis of Evidence- and Consensus-Based Recommendations Based on an Interdisciplinary Guideline Project
Introduction: Due to potentially severe sequelae (impaired growth, condylar resorption, and ankylosis) early diagnosis of chronic rheumatic arthritis of the temporomandibular joint (TMJ) and timely onset of therapy are essential. Aim: Owing to very limited evidence the aim of the study was to iden...
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| Autoren: | , , , , |
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| Format: | Artikel |
| Sprache: | Englisch |
| Veröffentlicht: |
Philipps-Universität Marburg
2023
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| Schlagworte: | |
| Online Zugang: | PDF-Volltext |
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| Zusammenfassung: | Introduction: Due to potentially severe sequelae (impaired growth, condylar resorption, and
ankylosis) early diagnosis of chronic rheumatic arthritis of the temporomandibular joint (TMJ) and timely onset of therapy are essential. Aim: Owing to very limited evidence the aim of the study was
to identify and discuss controversial topics in the guideline development to promote further focused
research. Methods: Through a systematic literature search, 394 out of 3771 publications were included
in a German interdisciplinary guideline draft. Two workgroups (1: oral and maxillofacial surgery,
2: interdisciplinary) voted on 77 recommendations/statements, in 2 independent anonymized and
blinded consensus phases (Delphi process). Results: The voting results were relatively homogenous,
except for a greater proportion of abstentions amongst the interdisciplinary group (p < 0.001). Eightyfour
percent of recommendations/statements were approved in the first round, 89% with strong
consensus. Fourteen recommendations/statements (18.2%) required a prolonged consensus phase
and further discussion. Discussion: Contrast-enhanced MRI was confirmed as the method of choice
for the diagnosis of TMJ arthritis. Intraarticular corticosteroid injection is to be limited to therapyrefractory
cases and single injection only. In adults, alloplastic joint replacement is preferable to
autologous replacement. In children/adolescents, autologous reconstruction may be performed
lacking viable alternatives. Alloplastic options are currently still considered experimental. |
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| Beschreibung: | Gefördert durch den Open-Access-Publikationsfonds der UB Marburg. |
| Umfang: | 20 Seiten |
| DOI: | 10.3390/jcm11071761 |