Stomatognathic system involvement in rheumatoid arthritis patients

Abstract

Aims:

Temporomandibular joint (TMJ) and stomatognathic system involvement are usually observed during the course of rheumatoid arthritis.

Methodology:

This article presents the findings during examination of 190 TMJs from rheumatoid arthritis (RA) patients, and 44 TMJs from controls without RA, including a description of signs and symptoms related to the stomatognathic system, radiological findings in hands-, and TMJ, erythrocyte sedimentation rate (ESR) values, and scores obtained in the Disease Activity Score (Das 28) and the Health Assessment Questionnaire (HAQ).

Results:

The sample included 57·89% TMJs associated with spontaneous pain, 87·89% with signs of destruction in radiological images, and 58·94% with 20 teeth or less. Restricted mouth opening was detected in 42·1% of RA patients, from which 71% had blocked opening; headache was present in 58%, and pain in the masticatory muscles was found in 57%. TMJ erosions had a significant association with Larsen scores (r = 0·62), but not with the Das 28, HAQ, and ESR values.

Conclusions:

The early evaluation of this joint and the collaborative work of odontologists and rheumatologists are both necessary for a better management of TMJ pathologies.

Keywords:

• Temporomandibular joint
• Rheumatoid arthritis
• DAS 28
• HAQ