Arthritis und Rheuma 2011; 31(06): 410-414
DOI: 10.1055/s-0037-1618094
Kinder-rheumatologie: Übersichtsbeitrag
Schattauer GmbH

Therapieansätze bei Kiefergelenksarthritis

Medikamente und Kieferorthopädie bei Kindern mit juveniler idiopathischer ArthritisTreatment approaches in temporomandibular joint arthritisdrugs and orthodontics in children with juvenile idiopathic arthritis
B. Koos
1   Universitätsklinik für Kieferorthopädie, UKSH Kiel
,
H. Fischer-Brandies
1   Universitätsklinik für Kieferorthopädie, UKSH Kiel
,
N. Tzaribachev
2   Dept. für Kinderrheumatologie, Klinikum Bad Bramstedt
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2017 (online)

Zusammenfassung

Die Kiefergelenke sind die wahrscheinlich am häufigsten betroffenen Gelenke bei Kindern mit juveniler idiopathischer Arthritis. Die therapeutischen Konzepte sind komplex und basieren neben der Verabreichung von lokal und systemisch wirkenden Medikamenten auch auf die kieferorthopädische Versorgung. Für die Wahl der Medikamente stellt sich grundsätzlich die Frage nach dem Befall auch anderer Gelenke und somit einer eher systemischen Therapie. Im Gegensatz dazu steht die isolierte Kiefergelenksarthritis, die eher einer lokalen medikamentösen Behandlung unterliegen sollte. Kieferorthopädisch stehen unterschiedliche Behandlungsansätze zur Disposition, mit dem Ziel der Wiederherstellung von Form und Funktion.

Summary

The temporomandibular joints are probably the most frequently involved joints in children with juvenile idiopathic arthritis. Therapeutic concepts base upon local and systemic drugs and orthodontic treatment. The choice of a proper medication depends on the real number of arthritic joints, with a more systemic treatment approach in polyarticular disease course. Whereas isolated forms of temporomandibular joint arthritis should be treated locally. From orthodontic perspective different treatment approaches are available, aiming at restoring growth and function.

 
  • Literatur

  • 1 Petty RE, Southwood TR, Manners P. et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: 2ndrevision, Edmonton, 2001. J Rheumatol 2004; 31 (02) 390-392.
  • 2 Twilt M, Schulten AJ, Nicolaas P. et al. Facio-skeletal changes in children with juvenile idiopathic arthritis. Ann Rheum Dis 2006; 65: 823-825.
  • 3 Küseler A, Pedersen TK, Herlin T. et al. Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol 1998; 25 (07) 1406-1412.
  • 4 Beukelmann T, Patkar NM, Saag KG. et al. 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis: Initiation and Safety Monitoring of Therapeutic Agents for the Treatment of Arthritis and Systemic Features. Arthritis Care Res 2011; 63 (04) 465-482.
  • 5 Magni-Manzoni S, Epis O, Ravelli A. et al. Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis. Arthritis Rheum 2009; 61 (11) 1497-1504.
  • 6 Tzaribachev N, Fritz J, Horger M. Silent arthritis in JIA children with clinicaly inactive disease detected by MRI. Ann Rheum Dis 2011; 70 (Suppl. 03) 90.
  • 7 Ringold S, Torgerson TR, Egbert MA. et al. Intraarticular corticosteroid injections of the temporomandibular joint in juvenile idiopathic arthritis. J Rheumatol 2008; 35 (06) 1157-1164.
  • 8 Tzaribachev N, Fritz J, Thomas C. Long-term safety of intraarticular steroid injections for pediatric temporomandibular joint arthritis. Ann Rheum Dis 2009; 68 (Suppl. 03) 707.
  • 9 Fritz J, Thomas C, Tzaribachev N. et al. MRI-guided injection procedures of the temporo-mandibular joints in children and adults: technique, accuracy, and safety. AJR Am J Roentgenol 2009; 93 (04) 1148-1154.
  • 10 Cahill AM, Baskin KM, Kaye RD. et al. CT-guided percutaneous steroid injection for management of inflammatory arthropathy of the temporomandibular joint in children. AJR Am J Roentgenol 2007; 188: 182-186.
  • 11 Saurenmann RK, Muller L, Schroeder S. et al. Efficacy of intraarticular steroid injection into the temporomandibular joint in children with juvenile idiopathic arthritis. ACR. 2009 SUN243.
  • 12 Stoustrup P, Kristensen KD, Küseler A. et al. Reduced mandibular growth in experimental arthritis in the temporomandibular joint treated with intraarticular corticosteroid. Eur J Orthod 2008; 30 (02) 111-119.
  • 13 Habibi S, Ellis J, Strike H. et al. Safety and efficacy of ultrasound guided corticosteroid injections into temporomandibular joints in children with active juvenile idiopathic arthritis. Pediatric Rheumatology 2011; 9 (Suppl. 01) O27.
  • 14 Ince DO, Ince A, Moore TL. Effect of methotrexate on the temporomandibular joint and facial morphology in juvenile rheumatoid arthritis patients. Am J OrthodDentofacialOrthop 2000; 118: 75-83.
  • 15 Ringold S, Cron RQ. The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic. Pediatric Rheumatology 2009; 7: 11.
  • 16 Tzaribachev N. Certolizumab pegol is effective in polyarticular course JIA patients not responsive to other TNF Alpha antagonists. Ann Rheum Dis 2011; 70 (Suppl. 03) 408.
  • 17 von Bremen J, Ruf S. Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature. Orthod-Craniofac Res 2011; 14: 107-115.
  • 18 Farronato G, Carletti V, Maspero C. et al. Craniofacial growth in children affected by juvenile idiopathic arthritis involving the temporomandibular joint: functional therapy management. J ClinPediatr Dent 2009; 33 (04) 351-357.
  • 19 Laiho K, Savolainen A, Kautiainen H. et al. The cervical spine in juvenile chronic arthritis. Spine J 2002; 2 (02) 89-94.
  • 20 von Bremen J, Ruf S. Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature. OrthodCraniofac Res 2011; 14: 107-115.
  • 21 Farronato G, Carletti V, Maspero C. et al. Craniofacial growth in children affected by juvenile idiopathic arthritis involving the temporomandibular joint: functional therapy management. J ClinPediatr Dent 2009; 33 (04) 351-357.
  • 22 Laiho K, Savolainen A, Kautiainen H. et al. The cervical spine in juvenile chronic arthritis. Spine J 2002; 2 (02) 89-94.