Functional disturbances of the masticatory system related to temporomandibular joint involvement by rheumatoid arthritis

1987 ◽  
Vol 14 (5) ◽  
pp. 415-427 ◽  
Author(s):  
U.-M. ETTALA-YLITALO ◽  
S. SYRJÄNEN ◽  
P. HALONEN
2021 ◽  
Vol 48 (3) ◽  
pp. 43-45
Author(s):  
Md Abu Shahin ◽  
Sudhir Karmacharya ◽  
Md Ariful Islam ◽  
Mamun Khan ◽  
Abdulla Al Morshed ◽  
...  

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the rheumatologist. TMJ complaints are present in about more than 50% of patients of RA. TMJ is usually among the last joint to be involved and is associated with many clinical signs and symptoms of which pain is a major problem leading to inflammation, limited movements, swelling, joint stiffness, and muscle spasm. Here reported case is 64 years old male, ex-smoker, diagnosed case of diabetes mellitus for 7 years, hypertension for 2 years, came to hospital with the complains of pain in left jaw for 1 year. He had no history of other joint pain, morning stiffness or any deformities. The patient was diagnosed as a case of rheumatoid arthritis on the basis of inflammatory monoarthritis with high titer positive RA factor and anti CCP. The patient gradually improved after treatment with methotrexate. Inflammatory markers like ESR dropped down with the clinical improvement. TMJ is seldom joint to be affected first in the disease course. Bangladesh Med J. 2019 Sep; 48 (3): 43-45


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1120.1-1120
Author(s):  
M. Brahem ◽  
A. Ben Salem ◽  
H. Hachfi ◽  
R. Sarraj ◽  
S. Abedallatif ◽  
...  

Background:Rheumatoid Arthritis (RA) is the most common chronic inflammatory disease usually involves peripheral joints with a symmetric distribution. The temporomandibular joint (TMJ) is seldom joint to be affected first in the disease course.Objectives:The Aim of our study is to describe and to assess the prevalence of temporomandibular joint (TMJ)disorders in patients with Rheumatoid arthritis (RA).Methods:A cross sectional study including RA patients, which consulted or were hospitalized in Rheumatology department in Taher Sfar Hospital of Mahdia Tunisia, during a period of 10 months. The diagnosis of the RA was secured by the ACR/EULAR 2010, Rheumatoid Arthritis Classification Criteria. The clinical TMJ examination was performed by a trained dentist in the same hospital. We assessed TMJ pain with VAS (visual analog scale) which varies from 0 to 10. The following key parameters were evaluated: The pain on the TMJs by bilateral palpation; The TMJ sounds (clicking or crepitus) during opening closing of the mandible; dysfunction and movement alterations. Clinical and sociodemographic parameters were also determined.Results:Our study included 51 patients with an average age of 51.11 years ±12.4 [21-74years]. 50patients (92.6%of cases) were women and 8 patients (14.8%) were diabetic. Only one patient was a smoker. The mean duration of RA was 10.7 years 7.7± [10months-35years]. Rheumatoid factor (RF) was positive in 25 Patients (46.3%of cases). Anti-citrullinated peptide antibody (ACPA) was positive in 32 patients (59.3 %).41patients (75.4%) had radiological impairments and 28 (51.9%) had specific deformations of RA. The average disease activity score (DAS28-VS) and (DAS28-CRP) were respectively 4.1±1.5 [1.4-7.3] and 3.4±1.5 [1.24-6.71]. TMJ pain was present in 29 patients (56.9 %) which67.7% appeared before ten years. 5 patients (16.7%) had VAS more than 7 that mean a severe pain. TMJ involvement was bilateral in 64.3% and unilateral in 35.7 %. Functional difficulties were detected in 22 patients (44.9 %). TMJ examination had also revealed a limitation of mouth opening in 11 patients (21.2 %), a movement alteration in 13 patients (27.79 %), a clicking in joint mobility in 13 patients (81.3 %) and joint crepitus in 1 patient (6.3%). Disease duration was associated with TMJ pain(p=0.05) and mobility alterations (p=0.04). Functional difficulties of the TMJ were correlated with DAS28 (p=0.02). In our study we found also that duration of corticosteroid therapy had in impact on TMJ pain (p=0.01), functional difficulties (p=0.01) and movements alterations (p=0.004).Conclusion:TMJ is very rare to be affected in the early phase of the disease, thus patient may develop signs and symptoms in the course of time. Our study showed the frequency of TMJ disorders and the most important factors were the activity of RA and the duration of the disease course.Disclosure of Interests:None declared


2018 ◽  
Vol 21 (1) ◽  
pp. 44-53
Author(s):  
Shivlal Rawlani ◽  
Rahul Bhowate ◽  
Shivali Kashikar ◽  
Monika Khubchandani ◽  
Sudhir Rawlani ◽  
...  

The temporomandibular joint (TMJ) is one of the most complex joints in the body and its harmonious functioning is very important to maintain a normal masticatory system. The morphologic alterations and the asymmetrical position of the TMJ structures may lead the various clinicalsigns & symptoms. Morphology of the temporomandibular joint may be influenced by gender of patients, environmental factor and also food habits at various places. Objective: To evaluate the morphology of the temporomandibular joint using computed tomography, in order to determine the condyle shape, joint space and glenoid fossa roof thickness. Material and Methods: One hundred and six healthy patients (212 TMJs) who visited a private hospital (or the University’s Hospital) for CT brain scan were included to this cross-sectional study sample.The patients were aged between 20–50 years with an average age of 35.46 years. All the images were taken by positioning patients in supine position with 120kvp , 50ma,2.33minute exposure with 0.7mm thick slicesby computed topography machine in all three projection that is Axial, Coronal and Saggital view. Results: For all variables, the mean and standard deviation were calculated, based on gender, and TMJ sides. The Paired t-test was used and P<0.05 will be considered to be significant. Conclusion: Present study showed that thereis positive evidence of temporomandibular joint involvement in elderly patients. Change in morphology and position of condylar head with glenoid fossa and roof thickness are one of the most common cause of degenerative diseases.KeywordsTemporomandibular joint; Morphology; Condyle; Joint space.KeywordsTemporomandibular joint; Morphology; Condyle; Joint space


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