Temporomandibular joint involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis

Aliko, Ardita; Ciancaglini, R; Alushi, Adem; Tafaj, Argjend; Ruci, Dorina

doi:10.1016/j.ijom.2011.02.026

Cited by 104 publications

(108 citation statements)

References 50 publications

(63 reference statements)

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“…As a synovial joint, patients with RA are at risk of TMJ involvement, and 67-71% patients will have at least one symptom; however, the true prevalence depends on the population studied, diagnostic criteria, and means of TMJ assessment (1,2,7). 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).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

“…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%

“…Rheumatoid arthritis patients tend to have more frequent and severe symptoms, signs, and radiographic changes when compared with PA and AS (1,7,10). Crepitus, in particular, is considered to be an important sign of joint destruction (1,7).…”

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%

“…In severe cases, there is a loss of mandibular condylar support with resultant retrognathia, loss of posterior mandibular height, and anterior open bite (failure of the incisors to meet), which, at its worst, can cause intermittent airway obstruction, particularly when supine (1,14). In one study, 66% patients with RA of the TMJ had severe arthritis of the cervical spine, and 50% with RA affecting the cervical spine had severe arthritis of the TMJ (15).…”

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%

“…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%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

See 3 more Smart Citations

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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Correlation of clinical findings of temporomandibular joint with serological results in rheumatoid arthritis patients

Jalal

Ahmed

Saeed

et al. 2022

Clinical & Exp Dental Res

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Objectives This study aimed to determine the frequency of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis (RA) and to find out the correlation of serological tests with clinical symptoms of TMJs in RA patients. Patients and Methods This cross‐sectional study was performed on 40 patients with RA classified into two groups according to their duration of the disease. Clinical examination as well as laboratory tests were done for participants. Results The frequency of TMJ involvement clinically was 15% in Group A and 40% in Group B. The most frequently observed clinical symptom was facial pain (25%), and the slightest symptom was clicking (2.5%) during mouth opening. There was a positive correlation between ESR, RF, CRP and anti‐CCP and clinical sign and symptoms of TMJs in RA patients. An elevated ESR, RF CRP and anti‐CCP may indicate the presence of TMJ complains in RA patients. The chronicity of RA affects the frequency of TMJ involvement clinically, patients with longer disease duration have more clinical symptoms of TMJs. An elevated level of ESR, RF, CRP and anti‐CCP predict clinical symptoms of TMJs.

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The indirect antinociceptive mechanism of 15d‐PGJ₂ on rheumatoid arthritis‐induced TMJ inflammatory pain in rats

Quinteiro

Napimoga

Mesquita

et al. 2012

European Journal of Pain

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Temporomandibular joint involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis

Cited by 104 publications

References 50 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

Correlation of clinical findings of temporomandibular joint with serological results in rheumatoid arthritis patients

The indirect antinociceptive mechanism of 15d‐PGJ₂ on rheumatoid arthritis‐induced TMJ inflammatory pain in rats

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Temporomandibular joint involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis

Cited by 104 publications

References 50 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

Correlation of clinical findings of temporomandibular joint with serological results in rheumatoid arthritis patients

The indirect antinociceptive mechanism of 15d‐PGJ2 on rheumatoid arthritis‐induced TMJ inflammatory pain in rats

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The indirect antinociceptive mechanism of 15d‐PGJ₂ on rheumatoid arthritis‐induced TMJ inflammatory pain in rats