Oro‐facial evaluation of women with rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is an aggressive articular autoimmune disease that causes deformities and disability. The temporomandibular joint (TMJ) might be affected by this disease. Few controlled studies have evaluated bite force (BF) and oro-facial manifestations of this disease. To characterise oro-facial alterations in patients with RA, correlate these results with clinical and disease activity parameters and correlate BF with hand strength (HS). A cross-sectional study of 150 women was performed, (75 RA patients (RA group) and 75 healthy individuals (control group). The presence of articular sounds, pain on palpation of masseter, temporal and TMJ lateral pole, changes in occlusion, range of mandibular motion, measurement of BF in the incisor and molar regions and assessment of HS were evaluated. In relation to oro-facial evaluation there were statistical differences between the groups. There was correlation between BF and HS, in the RA group, this correlation was consistent in patients with natural teeth. Patients with RA had lower scores (P < 0·05) in the HAQ, DASH and OHIP-14 questionnaires than the control group. Inverse correlations were found between BF and HAQ, but not between BF and DAS-28, DASH and OHIP-14 questionnaires in the RA group. The women with RA presented more signs and symptoms in the oro-facial region and had a lower BF than the women in the control group. BF was inversely correlated with the overall function (evaluated by the HAQ) in the patients with RA, and there were correlations between BF and HS in the RA patients and in the control group.

Temporomandibular joint findings in patients with rheumatoid arthritis, ankylosing spondylitis, and primary Sjögren's syndrome

“…Previous studies have reported that subjective TMJ symptoms were higher in patients with rheumatic diseases than in their controls. In the present study, subjective TMJ symptoms in patients with rheumatic disease, especially pSS, were found to be higher than in the control group.…”

Funções orofaciais em portadores de síndrome de Sjögren

“…A DTM geralmente, afeta mais as mulheres, na terceira década de vida e os principais sintomas relatados são: dificuldade para movimentar a boca, dor nos músculos da mastigação e ATMs, cansaço e dor para realizar funções estomatognáticas, como por exemplo, falar e mastigar, ruído nas articulações e dor que pode irradiar para cabeça e região cervical (Bataglion e Bataglion, 2009 (Hoyuela et al, 2015;Abrão et al, 2016).…”

“…Essas doenças frequentemente acometem as ATMs, provocam dor e alteram a função mandibular (Moen et al, 2005;Bessa-Nogueira et al, 2008;Hoyuela et al, 2015).…”

“…Embora a frequência de problemas na ATM em pacientes com AR relatada na literatura seja bastante variável (4,7-85%) (Hoyuela et al, 2015;Abrão et al, 2016), em um estudo recente, Hoyuela et al (2015) (Pierce et al, 2016;Eyigör et al, 2017).…”

“…De acordo com List et al (1999), nos casos de SS primária foi observado mais similaridades nos resultados dos exames clínicos com um grupo controle do que com o grupo com DTM e o mecanismo subjacente às limitações funcionais nessas doenças não são relacionados. Mas a ocorrência de DTM tem sido associada à SS secundária (Möen et al, 2005), porque esta desordem é comum em pacientes com artrite reumatóide (AR) (Bessa-Nogueira et al, 2008;Hoyuela et al, 2015).…”