AB0422 Orofacial evaluation in women with rheumatoid arthritis

Abstract

Background Rheumatoid arthritis (RA) can affect any synovial joint. Unlike the hand, ever so valued in the physical examination of patients with RA, the joints in the area of the jaw and neck may also be affected in this disease and have their involvement usually underdiagnosed. There are few studies evaluating the incidence of orofacial alteration in the examination as well as the correlation between bite force (BF) and clinical and functional parameters in these patients. Objectives The aim of our study was to compare the orofacial evaluation of women with RA with a control group, correlating orofacial function parameters with clinical disease activity in RA patients and hand strength in RA patients and control subjects. Methods We conducted a cross-sectional study with 150 women: half of them (n=75) were RA patients and the others (n=75) consisted the control group. The two groups were paired by age. All individuals we evaluated in relation to: pain duringmandibular function; TMJ pain at rest; TMJ sounds; tiredness during mastication; complaint of changes in the occlusion pattern; vertical range of motion of the mandible; reports chewing fatigue;reports of bruxism; reports of feeling morning stiffness in the TMJ; pain in TMJ lateral pole; BF of three regions: incisors and molars; assess the pinch (key,tip, palmar) and grip strenght; DASH and HAQ questionnaires; DAS 28 and OHIP14 questionnaire (Oral Health Impact Profile). Results The mean age (±SD) of the RA group was 49.2 years (±9.4) and 47.4 (±10.0) of the control group (p=0.244). Duration of disease of the RA group was 12.66 years (±9,32). Only 2 (2.6%) patients in the RA group reported TMJ pain at rest and during function; it was observed in RA and control group respectively: sounds in 36 (48.0%), 11 (14.6%); mouth opening in 44.13 mm (± 6.95), 46.48 mm (± 6.09); chewing fatigue in12 (16.0%), 5 (6.6%); pain inlateral pole TMJ in 29 (38.6%), 6 (8%); sleep bruxism in 21 (28.0%), 19 (25.3%); wakefulness bruxism in 13 (17.3%), 13 (17.3%); changes in the occlusion pattern in 7 (9.3%),1 (1.3%). The mean BF values of the RA and control groups in the three regions (incisors, right molars and left molars) were respectively: Incisor 92.8N (± 53.8), 126.5N (± 59.8), p=0.002; right molars 154.7N (± 104.4), 252.7N (± 149.7), p<0.001; 170.3N left molars (± 121.0), 249.2N (± 155.7), p=0.002. p<0.001; In RA group, there was no correlation between the BF and OHIP-14, DASH and DAS-28,was correlation and incisor force and key pinch (r=0.317,p=0.006), palmar pinch (r=0,317,p=0.006), and HAQ (r =- 0,488, p=0.0001);molar force and key pinch (r=0,275,p=0.032) and HAQ (r=-0.256,p=0.045). Conclusions We found women with RA have lower BF and more signs and symptoms in the orofacial region when compared to healthy ones. There was correlation between the BF and functional parametersand pinch strength in these patients. Disclosure of Interest None Declared