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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 identi...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999183/ https://www.ncbi.nlm.nih.gov/pubmed/35407368 http://dx.doi.org/10.3390/jcm11071761 |
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author | Schmidt, Christopher Reich, Rudolf Koos, Bernd Ertel, Taila Ahlers, Marcus Oliver Arbogast, Martin Feurer, Ima Habermann-Krebs, Mario Hilgenfeld, Tim Hirsch, Christian Hügle, Boris von Kalle, Thekla Kleinheinz, Johannes Kolk, Andreas Ottl, Peter Pautke, Christoph Riechmann, Merle Schön, Andreas Skroch, Linda Teschke, Marcus Wuest, Wolfgang Neff, Andreas |
author_facet | Schmidt, Christopher Reich, Rudolf Koos, Bernd Ertel, Taila Ahlers, Marcus Oliver Arbogast, Martin Feurer, Ima Habermann-Krebs, Mario Hilgenfeld, Tim Hirsch, Christian Hügle, Boris von Kalle, Thekla Kleinheinz, Johannes Kolk, Andreas Ottl, Peter Pautke, Christoph Riechmann, Merle Schön, Andreas Skroch, Linda Teschke, Marcus Wuest, Wolfgang Neff, Andreas |
author_sort | Schmidt, Christopher |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8999183 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89991832022-04-12 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 Schmidt, Christopher Reich, Rudolf Koos, Bernd Ertel, Taila Ahlers, Marcus Oliver Arbogast, Martin Feurer, Ima Habermann-Krebs, Mario Hilgenfeld, Tim Hirsch, Christian Hügle, Boris von Kalle, Thekla Kleinheinz, Johannes Kolk, Andreas Ottl, Peter Pautke, Christoph Riechmann, Merle Schön, Andreas Skroch, Linda Teschke, Marcus Wuest, Wolfgang Neff, Andreas J Clin Med Article 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. MDPI 2022-03-22 /pmc/articles/PMC8999183/ /pubmed/35407368 http://dx.doi.org/10.3390/jcm11071761 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Schmidt, Christopher Reich, Rudolf Koos, Bernd Ertel, Taila Ahlers, Marcus Oliver Arbogast, Martin Feurer, Ima Habermann-Krebs, Mario Hilgenfeld, Tim Hirsch, Christian Hügle, Boris von Kalle, Thekla Kleinheinz, Johannes Kolk, Andreas Ottl, Peter Pautke, Christoph Riechmann, Merle Schön, Andreas Skroch, Linda Teschke, Marcus Wuest, Wolfgang Neff, Andreas 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999183/ https://www.ncbi.nlm.nih.gov/pubmed/35407368 http://dx.doi.org/10.3390/jcm11071761 |
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