Surgical Treatment of Temporomandibular Joints in Patients with Chronic Arthritic Disease: Preoperative Findings and One-Year Follow-Up

ABSTRACT

Twenty-nine temporomandibular joints (TMJs) in 19 patients with chronic arthritic disease were surgically treated. Nine patients had rheumatoid arthritis (including two with juvenile type), six had ankylosing spondylitis and four had psoriatic arthropathy. Using a preauricular approach, diskectomies with synovectomies were performed in 23 joints (14 patients) with chronic arthritic abnormalities. Diskectomies without synovectomies were performed in six joints (five patients), which proved to have internal derangements unrelated to their chronic arthritic disease. Joints with chronic arthritis showed considerable variation in inflammatory reactions, but were characterized by increased vascularization, synovial proliferation to the articulating surfaces and mostly pannus formation and bone resorption. A response in pain relief was seen in 85% of the patients three months postoperatively and in 79% of the patients 12 months postoperatively and in 79% of the patients 12 months post-operatively, indicating that diskectomy with synovectomy may be favorable in patients with severe TMJ problems due, to involvement of chronic arthritic disease.

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Notes on contributors

Tore Bjørnland

Dr. Tore Bjørnland received his D.D.S. degree from Faculty of Dentistry. University of Bergen. Norway, in 1976. He completed the oral surgery residency program in Oslo, Norway, in 1984, and from 1985 to 1988 he was a research fellow in Oral Surgery, Faculty of Dentistry, Oslo. Since 1988 he has been an assistant professor in the Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo. He has been president of the Norwegian Association of Oral Surgery since 1989 and is the Norwegian representative in the European House of Representatives in Oral and Maxillofacial Surgery.

Tore A. Larheim

Dr. Tore A. Larheim received his D.D.S. degree in 1973 from the Faculty of Dentistry, University of Oslo, Norway. He became a research assistant in 1976 in the Department of Oral Radiology at the same university, received his Odont.Dr. (Ph.D.) degree in 1981, and then became associate professor of oral radiology. From 1985 he has been professor and chairman of the Department of Oral Radiology, Faculty of Dentistry, University of Oslo. He is a member of the Norwegian Dental Association, the International Association of Dento-Maxillo-Facial Radiology, and an associate member of the Norwegian Society of Radiology and Norwegian Society of Rheumatology.

Hans R. Haanæs

Dr. Hans R. Haanæs received his D.D.S. and M.D. degrees from the Dental and Medical Faculties, University of Oslo, in 1963 and 1976, respectively. He was Chief Resident in the Department of Oral and Maxillofacial Surgery at Vanderbilt University, School of Medicine, in Nashville, Tennessee, from 1977 to 1978. He became a professor in the Department of Oral Surgery and Oral Medicine, Oslo University, Dental Faculty, in 1979. Since 1985 he has been chairman of the department. He was president of the Norwegian Association of Oral Surgery from 1980 to 1986, a member of the board of the Scandinavian Association of Oral and Maxillofacial Surgery from 1983 to 1986, and a member of the Norwegian Research Committee from 1986 to 1991.