Two Cases of Rheumatoid Arthritis of the Temporomandibular Joints Treated by Intermaxillary Traction and the Arthroscopic Disc Suture / Fixation Technique

Abstract

Patients with severe rheumatoid arthritis of the temporomandibular joints (TMJ) often present with degenerative changes in the condylar process of the mandible and a reduction of the mandibular ramus, which leads to osteoarthrosis of the TMJ and resultant anterior open bite and retrognathism. This report documens the treatment of this type of problem with a new technique combining intermaxillary traction and arthroscopic disc suture / fixation. The intermaxillary traction of the upper and lower dentition was performed on two patients in order to bring the lower jaw back to its original position and improve occlusion. The disc was then sutured and fixed to the posterior wall of the upper joint cavity under arthroscopy to protect the condylar surface in the enlarged articular space. Both patients showed good postoperative stability after the remodeling of the condylar process of the mandible. As well as improved occlusion.