Steroid-induced damage to the condyles in treatment of idiopathic thrombocytopenia

A 17-year-old girl with a 5-month history of idiopathic thrombocytopenia (ITP) was referred to the authors because she was unable to bring her anterior teeth together without trismus or arthralgia. The patient had been treated with increasing doses of prednisolone up to 60 mg/day. The anterior open bite had begun after prednisolone medication. The problem was treated successfully with a separated type of intermaxillary elastic traction appliance. Magnetic resonance imaging scans disclosed internal and erosive damage to the condyles without disk displacement, but showed no sign of adaptive changes or functional remodeling. This is the first reported case of steroid-induced damage to the condyles caused by treatment for ITP.