The prevalence of temporomandibular disorders in patients with psoriasis with or without psoriatic arthritis

Derviş, Emine

doi:10.1111/j.1365-2842.2005.01521.x

Cited by 31 publications

(44 citation statements)

References 33 publications

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“…The duration and severity of PA and the number of somatic joints affected are the main risk factors for TMJ symptoms and signs, but the degree of skin involvement is not (3,4). Typical findings include clicking, crepitus, or other joint sounds; TMJ pain on mouth opening and chewing; morning stiffness; and muscle tenderness (3,4,17).…”

Section: Psoriatic Arthropathy 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: Psoriatic Arthropathy Of the Temporomandibular Jointmentioning

confidence: 99%

“…Typical findings include clicking, crepitus, or other joint sounds; TMJ pain on mouth opening and chewing; morning stiffness; and muscle tenderness (3,4,17). As the disease progresses, pain is replaced by the limitation of movement due to the development of fibrosis.…”

Section: Psoriatic Arthropathy 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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“…25,27 The TMJ and the masticatory muscles may be tender with palpation consistent with Hilton's Law. 26 Lundberg and Ericson first described the radiographic findings of TMJ PsA in 1967. 23 Radiographic signs are erosion, condylar flattening, subcortical sclerosis, and centric positional abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…23 Radiographic signs are erosion, condylar flattening, subcortical sclerosis, and centric positional abnormalities. 26 Several studies report that crepitation is most commonly associated with osteoarthritis. 28 MRI and CT should be a part of the routine workup of suspected patients with PsA.…”

Section: Discussionmentioning

confidence: 99%

“…In order to initiate a preliminary diagnosis three requirements must exist: psoriasis, erosive polyarthritis, and negative serologic test for rheumatoid factor (RF). 26 The onset of TMJ symptoms for this disease entity usually occurs by the fourth decade of life, most commonly expressed as pain and limitation of jaw range of motion. 25,27 The TMJ and the masticatory muscles may be tender with palpation consistent with Hilton's Law.…”

Section: Discussionmentioning

confidence: 99%

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The use of etanercept as a non‐surgical treatment for temporomandibular joint psoriatric arthritis: a case report

Lamazza

Guerra

Pezza³

et al. 2009

Australian Dental Journal

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Psoriatic arthritis (PsA) is a chronic inflammatory disease of the skin and joints characterized by extensive intra-articular bone resorption and silver-red scaly plaques most commonly found on extensor surfaces of the skin. When this arthritis affects the temporomandibular joint (TMJ) and does not successfully halt in its early degenerative process, patients may undergo invasive joint reconstruction that irreversibly changes the TMJ physiologic joint dynamics. This study presents a case of TMJ PsA: anterior open bite, limited range of motion, and erythematous desquamative plaques of the upper limb extensors surfaces. The patient previously received non-steroidal anti-inflammatory drugs, immunosuppressors, and corticosteroids over a four-year period while suffering the idiosyncratic drug side effects from long-term therapy without improvement in joint function or rash resolution. The treatment team then chose etanercept, a synthetic fusion protein therapy that binds with tumor necrosis factor (TNF)-alpha, to interrupt reactive inflammatory arthritis. The patient received the TNF-alpha inhibitor monthly for two years. This last treatment led to full remission of both joint symptomatology and skin lesions. Our results should encourage general dental practitioners' involvement in curing patients with psoriatic arthritis when it affects the TMJ.Key words: Etanercept, psoriatic arthritis, TMJ, immunomodulators.Abbreviations and acronyms: MRI = magnetic resonance imaging; NSAIDs = non-steroidal anti-inflammatory drugs; PASI = Psoriasis Area and Severity Index; PsA = psoriatic arthritis; RF = rheumatoid factor; TMJ = temporomandibular joint; TNF = tumor necrosis factor.

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Objective Signs

Hartmann¹,

Cucchi²

2013

Stress and Orality

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The prevalence of temporomandibular disorders in patients with psoriasis with or without psoriatic arthritis

Cited by 31 publications

References 33 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

The use of etanercept as a non‐surgical treatment for temporomandibular joint psoriatric arthritis: a case report

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