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.

Delphi method chronic rheumatic arthritis of the temporomandibular joint consensus guideline juvenile idiopathic arthritis rheumatoid arthritis

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
22 Mar 2022
Historique:
received: 16 02 2022
revised: 18 03 2022
accepted: 19 03 2022
entrez: 12 4 2022
pubmed: 13 4 2022
medline: 13 4 2022
Statut: epublish

Résumé

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). Eighty-four 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 therapy-refractory 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.

Identifiants

DOI: 10.3390/jcm11071761 PMID: 35407368 PMC: PMC8999183
pubmed: 35407368
pii: jcm11071761
doi: 10.3390/jcm11071761
pmc: PMC8999183
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Christopher Schmidt (C)

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps University, 35043 Marburg, Germany.

Rudolf Reich (R)

Practice for Oral and Maxillofacial Plastic Surgery MVZ R(h)einZahn, 53111 Bonn, Germany.

Bernd Koos (B)

Department of Orthodontics, University Hospital Tübingen, Eberhard Karls University Tübingen, 72074 Tübingen, Germany.

Taila Ertel (T)

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps University, 35043 Marburg, Germany.
Medical Clinic, Hospital of Winsen, 21423 Winsen (Luhe), Germany.

Marcus Oliver Ahlers (MO)

Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Hospital Hamburg-Eppendorf, University of Hamburg, 20146 Hamburg, Germany.
CMD-Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
ORCID: 0000-0001-9536-7259

Martin Arbogast (M)

Department of Rheumatic Orthopedics and Hand Surgery, Hospital Oberammergau, 82487 Oberammergau, Germany.

Ima Feurer (I)

Physiotherapeutic Practice & Orthopedic Manual Therapy, 78315 Radolfzell-Böhringen, Germany.

Mario Habermann-Krebs (M)

Deutsche Rheuma-Liga Bundesverband e.V. (German Patients' Association for Rheumatic Disorders), 53111 Bonn, Germany.

Tim Hilgenfeld (T)

Department of Neuroradiology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69120 Heidelberg, Germany.
ORCID: 0000-0002-3458-8899

Christian Hirsch (C)

Clinic of Pediatric Dentistry, University Hospital Leipzig, University of Leipzig, 04103 Leipzig, Germany.

Boris Hügle (B)

German Centre for Pediatric Rheumatology, Childrens' Hospital Garmisch-Partenkirchen, 82467 Garmisch-Partenkirchen, Germany.

Thekla von Kalle (T)

Department of Pediatric Radiology, Olgahospital, Klinikum Stuttgart, 70174 Stuttgart, Germany.

Johannes Kleinheinz (J)

Department of Cranio-Maxillofacial Surgery, University Hospital Münster, 48169 Münster, Germany.

Andreas Kolk (A)

Department of Oral and Craniomaxillofacial Surgery, University Hospital Innsbruck, Leopold-Franzens-University Innsbruck, 6020 Innsbruck, Austria.

Peter Ottl (P)

Department of Prosthodontic Dentistry, University Hospital Rostock, University of Rostock, 18057 Rostock, Germany.

Christoph Pautke (C)

Medical Practice & Clinic for Oral and Maxillofacial Surgery, 80333 Munich, Germany.

Merle Riechmann (M)

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps University, 35043 Marburg, Germany.

Andreas Schön (A)

Medical Practice & Clinic for Oral and Maxillofacial Surgery, 53842 Troisdorf, Germany.

Linda Skroch (L)

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps University, 35043 Marburg, Germany.

Marcus Teschke (M)

Medical Practice for Oral and Craniomaxillofacial Surgery, 61352 Bad Homburg, Germany.
Children's Hospital Wilhelmstift, 22149 Hamburg, Germany.

Wolfgang Wuest (W)

Department of Radiology, Hospital Martha Maria Nürnberg, 90491 Nuremberg, Germany.

Andreas Neff (A)

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps University, 35043 Marburg, Germany.
ORCID: 0000-0001-5865-0020

Classifications MeSH