Temporomandibular disorders in patients with rheumatoid arthritis: A clinical study
Objectives: The aim of this study is to evaluate the prevalence and type of temporomandibular disorders (TMD) in patients with rheumatoid arthritis (RA).
Materials and Methods: Fifty‑four patients having RA treatment at Cukurova University in Rheumatology Clinic were enrolled to the study. Demographic and rheumatologic data were recorded. The patients were examined in Dental Faculty by using Research Diagnostic Criteria/TMD (RDC/TMD) axis I and answered RDC/TMD axis II Biobehavioral Questionnaire. Data were evaluated according instructions for scoring and assessment of RDC/TMD. Mann–Whitney test was performed to compare continuous variables between two groups and Kruskal–Wallis test was performed to compare continuous variables for more than two groups.
Results: Although their activity situations were 55.6% active and 44.4% inactive, the distribution of treatment modality was 31.5% for anti‑tumor necrosis factor‑α (TNF‑α) and 68.5% for disease‑modifying antirheumatic drugs (DMARD). The distribution of temporomandibular joint (TMJ) involvement was; 9.3% with no involvement, 7.4% with joint involvement, 64.8% with muscular involvement, 18.5% with both muscular and joint involvement. Rheumatologic functional scores were (0) 3.7%, (1) 50%, (2) 38.9%, (3) 7.4%. Patients’ chronic pain was graded from 0 to 4 and the distribution was 3.7%, 24.1%, 20.4%, 31.5% and 20.4%, respectively. The mean duration of RA for anti‑TNF‑α (11.47 ± 7.67) was significantly higher compared with DMARD (7.09 ± 5.21) P = 0.040.
Conclusion: There was a high prevalence of TMD in RA patients, and muscular involvement was the highest among the TMJ involvements. Thus, this study supports TMJ examination should be encouraged in the rheumatology settings.
Keywords: Research Diagnostic Criteria, rheumatoid arthritis, rheumatologic functional score, temporomandibular joints, temporomandibular disorders