scholarly journals AB0192 EVALUATION OF TEMPOROMANDIBULAR JOINT INVOLVEMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1120.1-1120
Author(s):  
M. Brahem ◽  
A. Ben Salem ◽  
H. Hachfi ◽  
R. Sarraj ◽  
S. Abedallatif ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Chronic Inflammatory Disease ◽  
Joint Involvement ◽  
Disease Course ◽  
Cross Sectional ◽  
Functional Difficulties ◽  
Tmj Pain

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

scholarly journals Temporomandibular Joint Monoarthritis in Rheumatoid Arthritis - A Rare Case Report

2021 ◽  
Vol 48 (3) ◽  
pp. 43-45
Author(s):  
Md Abu Shahin ◽  
Sudhir Karmacharya ◽  
Md Ariful Islam ◽  
Mamun Khan ◽  
Abdulla Al Morshed ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporomandibular Joint ◽  
High Titer ◽  
Clinical Signs ◽  
Joint Stiffness ◽  
Signs And Symptoms ◽  
Joint Inflammation ◽  
Joint Involvement ◽  
Inflammatory Disorder ◽  
Clinical Signs And Symptoms

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

PREVALENCE OF TEMPOROMANDIBULAR DISORDERS AND ITS RELATION TO MALOCCLUSION AMONG ODONTOSTOMATOLOGY STUDENTS IN HUE MEDICAL AND PHARMACEUTICAL UNIVERSITY

2016 ◽  
pp. 85-93
Author(s):  
Anh Dao Hoang ◽  
Xuan Viet Anh Tran ◽  
Minh Tam Nguyen
Keyword(s):  
Clinical Examination ◽  
Temporomandibular Disorders ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
University Hospital ◽  
Cross Sectional ◽  
Tmj Pain ◽  
Hospital Study ◽  
The Relationship ◽  
Symptoms And Signs

Objective: (1) To determine the percentage of symptoms and signs of temporomandibular disorders (TMD); (2) To determine the rate of occlusal traits; (3) To determine the relationship between the signs of TMD and malocclusion traits. Methods: A cross-sectional descriptive study on 201 22-to 24-year-old students studying in Hue University Hospital. Study consists of two main parts: Interviews collected information about symptoms of pain and dysfunction of TMD during 6 months ago. Clinical examination of pain and dysfunction signs through the following components: (1) range of jaw motion, (2) the mouth opening path, (3) temporomandibular joint (TMJ) sounds, (4) and (5), muscle and/or TMJ pain by palpation; (6) malocclusion traits. Results: 72.6% of students had at least one TMD symptoms or signs. There were more students having signs (24.8%) detected by clinical examination than ones being aware of symptoms (8.0%). There was significant correlation between TMJ sounds and molars relationship (p = 0.049); between tooth malposition and TMJ sounds (p = 0.002). Conclusions: Prevalence of TMD signs and symptoms was high and some malocclusion traits were related to TMD. Key words: Temporomandibular disorders, maloclussion traits

scholarly journals Impact of Temporomandibular Joint Pain in Rheumatoid Arthritis

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Neveen Ahmed ◽  
Hamid Masoud Mustafa ◽  
Anca Irinel Catrina ◽  
Per Alstergren
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Pain Intensity ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Daily Activities ◽  
Inflammatory Activity ◽  
Tmj Pain ◽  
The Impact

To investigate the impact of temporomandibular joint (TMJ) pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA), thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0–10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28), blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA.

scholarly journals Corticosteroid injections in the temporomandibular joint temporarily alleviate pain and improve function in rheumatoid arthritis

2021 ◽  
Author(s):  
Johanna Margaretha Kroese ◽  
Sigvard Kopp ◽  
Frank Lobbezoo ◽  
Per Alstergren
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Intensity ◽  
Temporomandibular Joint ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Mouth Opening ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Tmj Pain ◽  
Corticosteroid Injections

Abstract Objectives To evaluate the effect of corticosteroid injections in the painful temporomandibular joint (TMJ) of patients with rheumatoid arthritis (RA) in relation to systemic inflammatory activity. Method Examination of 35 patients (median age 54 years; 89% female) included maximum mouth opening capacity, degree of anterior open bite (AOB), TMJ pain intensity at rest, and crepitus. Serum levels of rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serotonin, and plasma levels of interleukine-1β (IL-1β) were determined. Out of the 70 examined joints, 53 joints received a corticosteroid (methylprednisolone) injection after the clinical examination at baseline (T0). The examination was repeated for all patients at T1 (median 3.1 weeks after T0), and for 21 patients at T2 (median 6.3 weeks after T1), of whom 20 patients received a second injection at T1. Results Maximum mouth opening capacity significantly increased, and TMJ pain intensity significantly decreased between T0 and T1, but these improvements were no longer present at T2. No differences were found in AOB between the time points. Of the joints that received an injection at T0, 19 joints had pretreatment crepitus, which resolved in eight joints at T1. No correlations were found between the change in mouth opening capacity or TMJ pain intensity and ESR, CRP, serotonin, or IL-1β. Conclusions Methylprednisolone injections in the TMJ alleviate pain and improve mouth opening capacity for approximately 3 weeks, allowing patients to perform jaw exercises during this timeframe of temporary relief. It thus seems useful for the short-term management of TMJ involvement in RA. Key Points• In rheumatoid arthritis, corticosteroid injection in the temporomandibular joint alleviates pain and improves function.• The clinical improvement achieved with methylprednisolone injections lasts for approximately 3 weeks.• Corticosteroid injections could be used to facilitate and support additional noninvasive, conservative treatment options.

Immuno-biological Assessments of Temporomandibular Joint Disease in Patients with Immune-mediated Rheumatic Conditions. A cross sectional study of 273 cases

2018 ◽  
Vol 68 (12) ◽  
pp. 2987-2991
Author(s):  
Cristina Iordache ◽  
Bogdan Vascu ◽  
Eugen Ancuta ◽  
Rodica Chirieac ◽  
Cristina Pomirleanu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Temporomandibular Joint ◽  
Final Analysis ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immune Parameters ◽  
Immune Mediated

Temporomandibular joint (TMJ) is commonly involved in various immune-mediated rheumatic disorders accounting for significant disability and impaired quality of life. The aim of our study was to assess inflammatory and immune parameters in patients with TMJ arthritis related to rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to identify potential relation with severity and dysfunction of TMJ pathology. We performed a cross-sectional study in a cohort of 433 consecutive RA, 32 JIA, 258 AS, and 103 PsA. Only patients presenting with clinically significant TMJ involvement (273) related to their rheumatic condition were included in the final analysis. TMJ involvement is traditionally described in chronic inflammatory rheumatic disorders, particularly in patients with higher levels of inflammation as detected in rheumatoid arthritis and psoriatic arthritis. Disease activity and severity, as well as biological and positive serological assessments (rheumatoid factor, anti-cyclic citrullinated peptide, IL-1) remain significant determinants of the severity of TMJ arthritis.

scholarly journals Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Willemijn F. C. de Sonnaville ◽  
Caroline M. Speksnijder ◽  
Nicolaas P. A. Zuithoff ◽  
Daan R. C. Verkouteren ◽  
Nico W. Wulffraat ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Healthy Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Explanatory Factors ◽  
Left And Right

Abstract Background Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. Methods This cross-sectional study included children with JIA and healthy children of age 6–18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. Results A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. Conclusion All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.

scholarly journals Temporomandibular joint dysfunction in Parkinson's Disease: an integrative literature review

Revista CEFAC ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 702-711 ◽  
Author(s):  
Taysa Vannoska de Almeida Silva ◽  
Maria das Graças Wanderley de Sales Coriolano ◽  
Carla Cabral dos Santos Accioly Lins
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Temporomandibular Joint ◽  
Myofascial Pain ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Masticatory Muscles ◽  
Therapeutic Interventions ◽  
Temporomandibular Joint Dysfunction ◽  
Language Restriction

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.

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