The temporomandibular joint in rheumatoid arthritis: correlations between clinical and tomographic features

Goupille, P.; Fouquet, B.; Goga, D.; Cotty, P; Valat, Jean‐Pierre

doi:10.1016/0300-5712(93)90023-j

Cited by 64 publications

(53 citation statements)

References 16 publications

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“…Nevertheless, occasionally some patients develop progressive TMJ arthritis, which ultimately results in distracted condylar surface-induced pain, dysfunction of mandibular movement, and the development of an anterior open bite. [1][2][3][4] Our case developed an anterior open bite deformity ( Figure 1A) due to the severely eroded articular surfaces of both side condyles, as noted on the lateral tomograms and MRI (Figures 2 and 3). In general, TMJ replacement therapy or costochondral grafting of the TMJ provides a surgical solution for such patients.…”

Section: Discussionmentioning

confidence: 75%

“…The common clinical findings in RA of the TMJ are tenderness, pain, clicking, crepitation, stiffness, and limitation in jaw movements. 1,2 In patients with progressive disease, the joint space becomes obliterated due to loss of condylar height and retrognathia, and an anterior open bite deformity occurs due to destruction, erosion, sclerosis, and flattening of the articular surface of the condyle and eminence. 3,4 These patients occasionally require a surgical approach, such as TMJ replacement therapy or costochondral grafting of the TMJ to solve the anterior open bite deformity.…”

Section: Introductionmentioning

confidence: 99%

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The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Sasaguri

Ishizaki-Takeuchi

Kuramae

et al. 2009

The Angle Orthodontist

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A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Sasaguri

Ishizaki-Takeuchi

Kuramae

et al. 2009

The Angle Orthodontist

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“…The 48 TMJs of the RA patients were assessed according to the TMJ clinical dysfunction score (CDS) as the presence of TMJ symptoms and signs were recorded. [25] Radiological grading of the hands and feet of the studied RA patients was assessed, and percentage damage was calculated according to the modified Larsen score. [26] Informed consents were obtained from the patients, and the local ethics committee approved the study.…”

Section: Methodsmentioning

confidence: 99%

“…Both the reconstructed coronal and corrected sagittal views were assessed for the shape of the mandibular condyle, presence of any bony abnormalities, and condylar position during maximal mouth opening by using the CT TMJ score. [25] For optimum visualization of the anatomical structures under examination, a bone reconstruction algorithm was used. The obtained axial images were transformed into isotropic coronal and corrected sagittal images to obtain MPR for visualization of the articular surfaces.…”

Section: Multislice Computed Tomography Scanningmentioning

confidence: 99%

Using Clinical and Multislice Computer Tomographic Features to Assess Temporomandibular Joint Osseous Involvement in Rheumatoid Arthritis: A Preliminary Study

et al. 2012

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Amaç: Bu çalışmada, romatoid artrit (RA) hastalarında çok kesitli bilgisayarlı tomografi (ÇKBT) taraması ve multiplanar rekonstrüksiyon (MPR) ile temporomandibüler eklemin (TME) osseöz tutulumu değerlendirildi ve klinik, laboratuvar ve radyolojik hastalık parametreleri açısından bir ilişki olup olmadığı araştırıldı. Hastalar ve yöntemler:Çalışmaya kesin RA tanısı konmuş 24 kadın hasta (ort. yaş 35.5±6.6 yıl; dağılım 38.3-42 yıl) dahil edildi. Değerlendirme tıbbi öykü, fizik muayene ve klinik araştırma ile gerçekleştirildi. Yirmi sekiz eklemde Hastalık Aktivite Skoru (DAS28) hesaplandı ve Sağlık Değerlendirme Anketi-II (HAQ-II) yapıldı. Hastaların TME'leri TMJ klinik disfonksiyon skoruna göre değerlendirildi. El ve ayakların radyolojik evrelemesi modifiye Larsen skoru esas alınarak yapıldı. Çok kesitli bilgisayarlı tomografi bulguları, TME BT skoru kullanılarak değerlendirildi. Bulgular: Hastaların %70.83'ünde TMJ tutulumu mevcuttu. En sık rastlanan klinik TME disfonksiyon belirtileri zorlu manipülasyon ve ağrı, hassasiyet (%45.83), tık sesi (%29.17), kilitlenme (%16.67) ve takiben ağzın değişen ölçülerde açılması (%8.33) idi.. İki taraflı MRP taramasından sonra daha fazla sayıda hastada osseöz TME tutulumuna rastlandı (%83.33). En sık rastlanan bulgular mandibuler kondil erozyonları, değişen kondil pozisyonu, mandibuler subkondral skleroz, artiküler eminens düzleşmesi değişen kondil şekli ve artiküler fossa erozyonu, osteofitler, artiküler eminence erozyonu ve takiben mandibuler subkondral kistlerdi. Hastaların %41.67'sinde ağız açıklığı görünür şekilde azalmıştı. Temporomandibuler eklemin BT skoru, DAS28 ve modifiye Larsen skoru ile arasında bir korelasyon eğiliminin mevcut olduğunu gösterdi.Sonuç: Çok kesitli bilgisayarlı tomografi ve MPR, RA hastalarında klinik belirtiler ve hastalık aktivitesi ile ilişkili TME tutulumunun hesaplanmasında tanısal açıdan güvenilir bir yöntemdir. Semptomatik TME olan RA hastaları için erken değerlendirme büyük önem taşır.Anahtar sözcükler: Multiplanar rekonstrüksiyon; çok kesitli bilgisayarlı tomografi; romatoid artrit; temporomandibuler eklem. Objectives:In this study, we aimed to assess the osseous involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients by multislice computed tomography (MSCT) scanning with multiplanar reconstruction (MPR), and to find any relation to the clinical, laboratory and radiological disease parameters. Patients and methods:Twenty-four female patients (mean age 35.5±6.6 years; range 38.3 to 42 years) with definite diagnosis of RA were recruited in the study. Assessment was conducted through medical history, physical examination and clinical investigation. Disease Activity Scores in 28 Joints (DAS28) was calculated and Health Assessment Questionnaire-II (HAQ-II) used. The TMJs were assessed according to the TMJ clinical dysfunction score. Radiological grading of hands and feet was performed according to the modified Larsen score. Findings of the MSCT were assessed using the TMJ CT score.Results: Temporomandibular joint invol...

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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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The temporomandibular joint in rheumatoid arthritis: correlations between clinical and tomographic features

Cited by 64 publications

References 16 publications

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Using Clinical and Multislice Computer Tomographic Features to Assess Temporomandibular Joint Osseous Involvement in Rheumatoid Arthritis: A Preliminary Study

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

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