Alloplastic Temporomandibular Joint Reconstruction for Patients With Juvenile Idiopathic Arthritis

Purpose: The purpose of this study was to assess the efficacy of alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) in patients with juvenile idiopathic arthritis (JIA). Materials and Methods: All patients with a formal diagnosis of JIA requiring a TMJ patient-specific TJR between 2010 and 2018 at The University of Texas-Health at San Antonio were retrospectively analyzed. To be included, patients must have had a formal diagnosis of JIA, complete records, and TMJ reconstruction with the TMJ Concepts patient-specific total joint prosthesis (TMJ Concepts, Ventura, CA). Clinical data acquisition was required at a minimum of 12 months after surgery (longest follow-up [LFU]). Subjective and objective analyses were performed using a 10-point visual analog scale at the preoperative and LFU time points. Surgical data at the perioperative and LFU time points were recorded for comparison. Results: Twenty patients with JIA met the inclusion criteria. The mean visual analog scale measurements for facial pain, TMJ pain, jaw function, diet, and disability were all significantly reduced at LFU. The maximal interincisal opening with pain was increased from 33.5 mm preoperatively to 44 mm at LFU, and the mean maximal interincisal opening without pain was increased from 31.1 mm preoperatively to 43 mm at LFU. None of the patients had complications from their TMJ TJR. Conclusions: Alloplastic TMJ reconstruction is a safe and efficacious treatment option for the surgical management of end-stage TMJ disease in JIA patients. (C) 2020 American Association of Oral and Maxillofacial Surgeons