Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic joint disease in childhood and represents a series of chronic inflammatory arthritides that develop before the age of 16 years. It normally persists for at least 6 weeks and have no identifiable cause and is significantly distinct from adult rheumatoid arthritis. JIA has been shown to affect up to 150 in 100,000 children around the globe and has a significant debilitating effect on these young children. In patients with JIA, TMJ involvement occurs more frequently than once thought. The “forgotten joint” is affected in approximately half the children with JIA. Depending on the subtype, TMJ involvement may occur in 17% to 87% and is often dependent on diagnostic criteria and ethnicity. Bilateral joint involvement occurs about 53% to 83% of the cases and the rates increase as the patient gets older. The onset of TMJ pathology varies from the onset of systemic JIA and the exact mechanism is unknown. Systemic management of patients requires the use of biological agents or “biologics. Orthodontic treatment with occlusal splints, functional appliances and regular braces. Surgical management by the Oral Maxillofacial Surgeons include TMJ corticosteroid injections, joint lavages with sodium hyaluronate injections, orthognathic surgery and total joint replacements. There is very little information on the comprehensive co-operation between Orthodontics and other medical specialties especially Rheumatology. This lecture will present the current trends and thoughts on JIA management.
Learning Objectives:
After this lecture, attendees will be able to:
Understand the role of the Orthodontist in JIA.
Understand the disease progression in JIA patients using modern technology.
Understand the multi-disciplinary approach to JIA management.
