Temporomandibular Joint Involvement in Rheumatoid Arthritis:<i>Relationship with Disease Activity</i>

Çeliker, Reyhan; Gökçe-Kutsal, Yeşim; Eryilmaz, Muzaffer

doi:10.3109/03009749509095149

Cited by 58 publications

(66 citation statements)

References 13 publications

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“…The likelihood of TMJ involvement correlates with the severity and duration of the systemic disease as tenderness in multiple peripheral joints is often accompanied by a painful TMJ (2,8,9). Typical clinical findings include joint pain, stiffness, sounds, and limitation of movement (2,8). TMJ pain and masticatory muscle tenderness suggest an active disease (1).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

“…Crepitus, in particular, is considered to be an important sign of joint destruction (1,7). Typical radiographic changes include cortical erosions, subcortical cysts, flattening of the condylar head and articular eminence, subcortical sclerosis, and narrowing of the joint space, but none of these are pathognomonic of RA (8,10,11).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

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Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

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IntroductionThe incidence of temporomandibular joint (TMJ) involvement in inflammatory arthritis is often underestimated, and experience in treatment among rheumatologists is limited. Three conditions have an affinity toward the TMJ: Rheumatoid arthritis (RA), psoriatic arthritis (PA), and ankylosing spondylitis (AS). The prevalence is the highest in RA, followed by PA (1-5).The disease processes differ from those seen in osteoarthritis or following trauma, which are characterized by degeneration or ankylosis, respectively, as joint destruction occurs. Furthermore, inflammatory arthropathies are systemic diseases that can lead to a relapse in symptoms, despite initially successful treatment, as TMJ inflammation continues. Immunosuppressive therapies used to ameliorate systemic inflammation may also complicate treatment responses, particularly if surgical management is required, as there is a theoretical increased risk of infection. In contrast, osteoarthritis symptoms may stabilize, previous joint trauma tends not to deteriorate unless TMJ ankylosis ensues, and immunosuppression is not required. Therefore, a different management approach is required in patients with inflammatory arthropathy that addresses both the systemic illness and localized TMJ disease.Pain, reduced mouth opening, joint noises, locking, and difficulty eating are the predominant symptoms and can be debilitating if left untreated. Pain originates from the TMJ itself, the associated masticatory muscles, or from both these areas, and it is manifested by tenderness on palpation of the respective anatomical area. Mouth opening is measured as the gap between the tips of the upper and lower incisors at maximal opening (interincisal distance) with less than 35 mm considered abnormal (6). Joint noises and locking result from the internal derangement of the joint mechanism, which consists of the mandibular condyle, intra-articular disc, and glenoid fossa, or from inflammatory debris deposited as part of the disease process. Combined with pain and restricted opening, these contribute toward problems in eating. 151Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged in...

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Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

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“…The likelihood of RA patients developing TMJ symptoms is related to the severity and duration of the systemic disease [8][9][10][11][12][13] . This fact has been reported since the very term Rheumatoid Arthritis was introduced in 1859, by Garrod, who believed RA had a peculiar tendency to affect such joint 14 .…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

“…This fact has been reported since the very term Rheumatoid Arthritis was introduced in 1859, by Garrod, who believed RA had a peculiar tendency to affect such joint 14 . TMJ involvement rate varies between 4.7% and 84% [8][9][10][11][12][13] . According to the literature, the most frequently reported symptoms are: joint pain, edema, joint crepitation, stiffness when opening the mouth and movement limitation [8][9][10][11][12][13][14] .…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Análise dos índices de Helkimo e craniomandibular para diagnóstico de desordens temporomandibulares em pacientes com artrite reumatóide

Cunha¹,

Nogueira²,

Duarte

et al. 2007

Rev. Bras. Otorrinolaringol.

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OBJETIVO: O estudo teve como finalidade avaliar a utilização de dois índices (Helkimo e craniomandibular) para o diagnóstico da desordem temporomandibular (DTM) em pacientes com Artrite Reumatóide (AR). MATERIAIS E MÉTODOS: A amostra foi de 80 pacientes divididos em dois grupos: pacientes com AR e pacientes sem AR. Em ambos os grupos os dois índices foram utilizados. No diagnóstico da DTM foram avaliados os seguintes sinais e sintomas: dor na ATM; limitação de abertura de boca e ruídos articulares. RESULTADOS: Os resultados mostram que dos pacientes com AR 87,1% eram do gênero feminino e 12,9% do masculino. Entre os pacientes sem AR, 70% eram do gênero feminino e 30% do masculino. A idade dos pacientes com AR variou de 24 a 78 anos. Entre os pacientes sem AR, a idade variou de 22 a 72 anos. Foi verificado que a prevalência de DTM foi mais elevada no grupo de pacientes com AR (98,6% - Helkimo e 87,1% - craniomandibular) do que no grupo sem a doença (80% - Helkimo e 50% - craniomandibular). CONCLUSÃO: Em resumo, temos que ambos os índices são capazes de diagnosticar a desordem temporomandibular em pacientes com AR, entretanto o Índice de Helkimo é menos preciso.

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“…The magnitude of TMJ involvement seems to be correlated with the severity of RA. The level of rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), thrombocytes count, and plasma tumor necrosis factor-α have all been noted to correlate with the severity of TMD [5][6][7][8][9][10][11][12][13]. Dental panoramic tomography has become a very popular radiographic technique in dentistry.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Temporomandibular Joint Diseases in Patients with Rheumatoid Arthritis by Panoramic Radiography and Magnetic Resonance Imaging

Eshak¹

2016

JDHODT

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Objective: To assess the temporomandibular joint in patients with rheumatoid arthritis by both panoramic radiography and MRI.Study design: Panoramic radiograph and MRI imaging were performed to forty joints of twenty patients from both sexes and varying ages, complaining of signs and/or symptoms of TMJ involvement. Diagnoses of Rheumatoid Arthritis were according to 1987 ACR criteria for RA. All images were analyzed and scored. Results:Comparison between panorama and MRI revealed that there was statistically significant difference regard condyles position in panorama and condylar osseous changes in MRI, temporal cortical bone integrity in panorama and osseous condylar changes in MRIs and finally joints space narrowing in panorama and disc position, disc morphology, and joint effusion in MRIs. While, there was no statistically significant difference regard condyles morphology in panorama and osseous condylar changes in MRIs, and finally joint space narrowing in panorama and revealed retrodiscal band hyper intense signal detected in MR images.

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Temporomandibular Joint Involvement in Rheumatoid Arthritis:Relationship with Disease Activity

Cited by 58 publications

References 13 publications

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

Análise dos índices de Helkimo e craniomandibular para diagnóstico de desordens temporomandibulares em pacientes com artrite reumatóide

Assessment of Temporomandibular Joint Diseases in Patients with Rheumatoid Arthritis by Panoramic Radiography and Magnetic Resonance Imaging

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