Juvenile idiopathische Arthritis (JIA) und das Kiefergelenk – Ein Update

Zusammenfassung

Die juvenile idiopathische Arthritis (JIA), als häufigste rheumatische Erkrankung im Kindesalter, ist vielfach durch eine mögliche Kiefergelenkbeteiligung für das Fachgebiet der Kieferorthopädie relevant. Eine Kiefergelenkarthritis kann – wie nachfolgend ausgeführt – mitunter negativen Einfluss auf die orofaziale Entwicklung und Ausbildung von kraniofazialen Anomalien haben. Eine frühzeitige Erstdiagnose kann die Qualität des Behandlungsergebnisses deutlich begünstigen. Die in diesem Update zur JIA im Weiteren vorgestellten Empfehlungen fassen die interdisziplinären Arbeiten der internationalen Expertengruppe euroTMjoint der letzten Jahre zusammen. Im Vordergrund steht dabei auch die erstmalige internationale und interdisziplinäre Konsensusempfehlung für die orofaziale Untersuchung und Überwachung von Patienten mit JIA zur Vereinheitlichung klinischer und wissenschaftlicher Parameter sowie Früherkennung einer Kiefergelenkbeteiligung.

Neben der Kieferorthopädie umfasst die Therapie der JIA weitere Säulen, wie die medikamentöse Therapie durch Kinderrheumatologen, Physiotherapie, psychosoziale Begleitung sowie weitere Therapieverfahren. Eine enge interdisziplinäre Zusammenarbeit ist hier notwendig.

Abstract

Juvenile idiopathic arthritis (JIA) is the most frequent rheumatic disease during childhood. Multiple cases involve the temporomandibular joint (TMJ) and are therefore relevant to orthodontists. TMJ arthritis can negatively affect orofacial growth up to the development of craniofacial anomalies. An early initial diagnosis can optimize treatment outcome. In this update on JIA, we present the recommendations by the international task force euroTMjoint which shall for the first time establish an internationally accepted consensus on orofacial examination and follow-up of patients with JIA in order to standardize clinical and research parameters as well as to early detect involvement of the TMJ. Orthodontic treatment of JIA is part of a treatment concept including medical treatment by pediatric rheumatologists, physiotherapy, psychosocial care and other therapies. A well attuned interdisciplinary team is crucial for treatment success.

Schlüsselwörter

Juvenile idiopathische Arthritis (JIA) - Kiefergelenk - Gesichtswachstum - kraniofaziale Fehlbildungen - Diagnose - Krankheitsverlauf

Key words

Juvenile idiopathic arthritis (JIA) - temporomandibular joint (TMJ) - facial growth - craniofacial anomaly - diagnosis - follow-up

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