The mandibular condyle in juvenile chronic arthritis patients with mandibular hypoplasia - A clinical and histological study

In 12 JCA patients with severe mandibular hypoplasia, who all strongly dema nded early treatment, 21 mandibular condyles were replaced by costochondral grafts. All of them had radiographic morphological changes in the mandibul ar condyles with varying degrees of destruction of the articular cartilages . Severe pathological changes in the lower joint compartments were consiste ntly observed at surgery. Hence, the lower joint compartments were obstruct ed with granulomatous tissue, whereas the upper compartments were without m acroscopic pathological changes. These findings indicated a polarized invol vement of the temporomandibular joint (TMJ) in juvenile chronic arthritis ( JCA). The extent of condylar articular surface destruction at histological examination varied from focal to total cartilage destruction. Inflammation of the subchondral bone marrow was a frequent finding. In spite of consider able arthritic destruction of the condyles, only one patient had TMJ pain, while a restricted mouth opening capacity was a more frequent finding. Thus , TMJ pain did not seem to constitute a reliable symptom of serious arthrit ic destruction of the mandibular condyle.