Alloplastic reconstruction of the temporomandibular joint in patient with rheumatoid arthritis: case report

LEANDRO EDUARDO KLUPPEL e CAIO AUGUSTO MUNUERA UETI

The inflammatory arthritis of the temporomandibular joint (TMJ) is uncommon, but when it occurs it can become debilitating. Early diagnosis and treatment by a maxillofacial surgeon can prevent joint collapse. The most prevalent form of inflammatory arthritis, the rheumatoid arthritis, when affects the TMJ, causes destruction of the mandibular condyle, with consequent retrusion of the chin, shortening of the mandible branch, and anterior open bite. Due to the reduction of the anteroposterior and posterior vertical dimensions of the mandible, there is a reduction in the upper airway space; and, in severe cases, it implies the development of obstructive sleep apnea syndrome. The aim of this study is to present a clinical case of advanced degenerative disease secondary to rheumatoid arthritis, with involvement of the temporomandibular joints, in association with mandibular and mental retrusion, and obstructive sleep apnea syndrome. The proposed treatment plan was orthognathic surgery associated with temporomandibular joint reconstruction with custom prostheses. The articular problem was resolved, facial harmony and aesthetics improved, and upper airway enlarged. The alloplastic reconstruction offers an effective treatment of patients with temporomandibular joint autoimmune disease, avoids donor site morbidity and allows correction of facial deformity in a single procedure.

Keywords: Temporomandibular joint. Arthritis, rheumaoid. Sleep apnea syndrome.

How to cite: artigo: Kluppel LE, Ueti CAM. Alloplastic reconstruction of the temporomandibular joint in patient with rheumatoid arthritis: case report. J Braz Coll Oral Maxillofac Surg. 2021 Sept-Dec;7(3):52-8.

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