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Published in: Oral and Maxillofacial Surgery 4/2018

01-12-2018 | Review Article

A novel treatment of temporomandibular joint arthritis as a complication in familial Mediterranean fever—literature review and a case report

Authors: Boaz Frenkel, Tal Berg, Amir Totry, Adi Rachmiel

Published in: Oral and Maxillofacial Surgery | Issue 4/2018

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Abstract

Objectives

Articular involvement in familial Mediterranean fever (FMF) ranges between 40 and 70% of the patients. Involvement of temporomandibular joint (TMJ) in FMF is very rare, and only a few cases have been reported in the literature. There are no specific guidelines for treatment. We hereby present a new treatment for TMJ inflammation in FMF.

Materials and methods

A literature search was performed using PubMed according to the following criteria: key terms included in the search were FMF arthritis, TMJ involvement in FMF patients, and arthroscopy in FMF patients. All keywords were included both as medical subject headings (MeSH) terms and text words. Selections were limited to the English language.

Results

Literature search yielded four reported cases of TMJ involvement in FMF patients. The four cases were treated differently, with no clear guidelines for management of TMJ involvement. Our patient suffered from painful swelling and redness over the involved TMJ area and severe trismus. She was treated by arthroscopic lysis and lavage of her TMJ followed by aggressive physiotherapy resulting to improvement of her mouth opening.

Conclusions

The adverse effect of TMJ arthritis in FMF patients can be avascular necrosis and destruction of the mandibular condylar head. TMJ arthroscopy allows lysis and lavage of the joint with minimal operative and postoperative complication, resulting with satisfactory results. Thus, in case of TMJ arthritis in FMF, we recommend TMJ arthroscopy as soon as possible, following aggressive physiotherapy in order to gain normal mouth opening.

Clinical relevance

FMF rates have been described among the Mediterranean and Middle Eastern population ranging from 1:5 to 1:3; thus, TMJ involvement due to the disease is not so rare in this region, and a clear treatment protocol is needed.
Literature
18.
go back to reference Simon G, Marbach JJ (1976) Familial Mediterranean fever with temporomandibular joint arthritis. Pediatrics 57(5):810–812PubMed Simon G, Marbach JJ (1976) Familial Mediterranean fever with temporomandibular joint arthritis. Pediatrics 57(5):810–812PubMed
Metadata
Title
A novel treatment of temporomandibular joint arthritis as a complication in familial Mediterranean fever—literature review and a case report
Authors
Boaz Frenkel
Tal Berg
Amir Totry
Adi Rachmiel
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 4/2018
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-018-0727-5

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