Pseudogout of the temporomandibular joint: a case report with systematic literature review

Background: Calcium pyrophosphate dihydrate deposition disease (CPPD) is a metabolic disease resulting in acute arthritis. CPPD often affects joints containing fibrocartilage. The purpose of this review is to examine the clinical presentations, prevalence, and treatment modalities associated with CPPD when it affects the temporomandibular joint (TMJ). Methods: A search, following PRISMA guideline, was conducted in various electronic databases (PubMed, Scopus, Web of Science) to find relevant studies about CPPD in the temporomandibular joint. The search spanned from 01 January 1980, to 31 January 2024. A case report was also presented. Results: A systematic review of literature identified 64 papers, reaching a total of 74 cases of CPPD of the temporomandibular joint TMJ. CPPD is a condition that typically affects middle-aged or older patients, with an average age of around 60 at the time of diagnosis. Females are affected more frequently than males. Most cases involve unilateral TMJ involvement, and common symptoms include pain, reduced mouth opening, and swelling. Different papers also describe severe stages of the invasion of muscles, parotid gland, and even brain structure. Surgery has the preferred treatment option for most Authors and is mandatory for late-stage lesions. The recurrence rate is extremely low. Conclusions: CPPD is an uncommon, locally invasive, and typically benign condition that rarely affects the TMJ. Distinguishing CPDD in the TMJ from other neoplasms poses diagnostic challenges. A definitive diagnosis necessitates histological examination and quantitative microanalysis. In our patient, successful excision of CPDD in the TMJ was achieved using an external approach. The PROSPERO Registration: PROSPERO number is CRD42024558402.

Calcium pyrophosphate dihydrate deposition disease; Pseudogout; Temporomandibular joint; Systematic review; Epidemiology

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