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Oksanen S, Sipilä K, Heliövaara M, Suominen AL, Huumonen S. Associations of inflammatory polyarthritis with clinical and radiological findings of temporomandibular disorders. Acta Odontol Scand 2024; 83:13-19. [PMID: 37812570 PMCID: PMC11302489 DOI: 10.1080/00016357.2023.2267118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/06/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To evaluate the association of different forms of inflammatory polyarthritis with clinical signs of temporomandibular disorders (TMD) and radiological findings in temporomandibular joint (TMJ), based on a nationwide health survey in Finland. The aim was also to assess the presence of clinical and radiological TMD findings in subjects with increased risk for developing rheumatoid arthritis (RA). MATERIAL AND METHODS Anationally representative sample included 6331 Finnish adults who participated in the Health 2000 Survey (BRIF8901). Subjects were examined for signs of TMD, findings in panoramic radiograph of TMJ, musculoskeletal health and serology (rheumatoid factor, RF, and anti-cyclic citrullinated peptide, aCCP). RESULTS Sixty-four percent of seronegative RAand 60% of seropositive RAsubjects had at least one sign of TMD. While adjusting for confounding factors (gender, age, dentures and smoking history), RAwas significantly associated with crepitation and abnormal radiological findings in TMJ. Seronegative RAwas also associated with restricted mouth opening. Systemic autoimmunity associated with RA("at risk of RA") was not associated with clinical or radiological TMD findings. CONCLUSIONS Clinical and radiological findings of TMD are more prevalent among subjects with inflammatory polyarthritis than among the population in general in the Finnish adult population.
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Affiliation(s)
- Sari Oksanen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Kirsi Sipilä
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Markku Heliövaara
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Institute of Dentistry, Kuopio University Hospital, Kuopio, Finland; Department of Public Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Institute of Dentistry, Kuopio University Hospital, Kuopio, Finland.
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Effat KG, Berty A. Otological symptoms in patients with rheumatoid arthritis of the temporomandibular joint. Cranio 2023:1-8. [PMID: 37747112 DOI: 10.1080/08869634.2023.2260281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The aim of the current study was to describe the pattern of otological symptoms in patients with rheumatoid arthritis (RA), having clinical temporomandibular joint (TMJ) involvement. This issue had not been previously addressed. METHODS A questionnaire and examination findings protocol was applied for 141 patients with RA and 141 control subjects. RESULTS Otological symptoms (otalgia, hearing loss, tinnitus, and vertigo), all had a significantly higher incidence in RA patients, compared to control subjects (P = .001). CONCLUSION The onset and maintenance of otological symptoms in patients with TMJ involvement by RA probably result from peripheral, as well as central nervous system alterations in sensory stimuli programming.
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Affiliation(s)
- Kamal G Effat
- Consultant Otolaryngologist, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Consultant Rheumatologist, St. Mark Rheumatology Center, Cairo, Egypt
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Piancino MG, Rotolo R, Cannavale R, Cuomo G, Masini F, Dalmasso P, D'Apuzzo F, Perillo L, Nucci L. Cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis. BMC Oral Health 2023; 23:269. [PMID: 37161398 PMCID: PMC10170686 DOI: 10.1186/s12903-023-03001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/29/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE The aim of this prospective cross sectional study was to evaluate the cranial structure and condylar asymmetry of adult patients with rheumatoid arthritis (RA) diagnosed after 25 years of age compared to a healthy adult control group. METHODS Eighteen adult patients (57.4 ± 11.4 years) with RA were compared with a control group. Cephalometric analysis and the Habets method for the calculation of the condylar asymmetry were used. The main cephalometric data investigated were focused on the diagnosis of hyperdivergent cranial structure (NSL/ML, NL/ML), backwards rotation of the mandible (Fh/ML), short vertical ramus (Ar:Go), steep mandibular plane (ML/Oc). RESULTS The cephalometric data considered were not significantly different in the RA vs controls except for the steepness of the occlusal plane (NL/Oc), which was steeper in the patients group (P < 0.02) and the ramus of the mandible which was greater in patients. The asymmetry of the condyles was significant (P < 0.003) and different from the control group, but that of the ramus was not. CONCLUSIONS In this study, RA patients diagnosed after 25 years of age did not show a different pattern of growth with respect to the control group. As expected, the condyles showed a difference being asymmetrical in RA patients due to the high turnover of this joint reacting to severe systemic inflammation in conditions of continuous functional work, load and forces. This study follows a previous study with the same research plan conducted on young JIA patients who showed a different pattern of growth of the skull leading to a severe hyperdivergent cranial structure with backward rotation of the mandible; this is mainly due to the insufficient growth of the condylar site exposed to the inflammatory process during development. Unlike JIA patients, this study showed that RA patients follow an individual growth pattern not affected by inflammation, even if they show joint asymmetry.
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Affiliation(s)
- Maria Grazia Piancino
- Department of Surgical Sciences-Orthodontic Division, Italian Research Center, University of Turin, Turin, Italy
| | - Rossana Rotolo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
| | - Rosangela Cannavale
- Department of Surgical Sciences-Orthodontic Division, Italian Research Center, University of Turin, Turin, Italy.
| | - Giovanna Cuomo
- Department of Precision Medicine, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Masini
- Department of Medical and Surgical Sciences, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
| | - Paola Dalmasso
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Fabrizia D'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of the Study of Campania Luigi Vanvitelli, Naples, Italy
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Temporomandibular joint disorders in patients with rheumatoid arthritis. Reumatologia 2021; 59:161-168. [PMID: 34538943 PMCID: PMC8436802 DOI: 10.5114/reum.2021.107593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/25/2021] [Indexed: 01/02/2023] Open
Abstract
Objectives The aim of this study is to draw the attention of patients, doctors and therapists to the importance of temporomandibular joint (TMJ) problems in rheumatoid arthritis (RA). Material and methods The research was conducted at the National Institute of Geriatrics Rheumatology and Rehabilitation in Warsaw. The study involved 60 subjects. The test group consists of 30 patients with diagnosed RA. The control group (n = 30) consisted of healthy participants of similar age. The study analyzed the occurrence of problems in TMJ joints, acoustic phenomena and the level of pain. Masseter muscle development, range of abduction motion and pain during palpation of soft tissues were assessed on the basis of the joint pain map of Prof. Mariano Rocabado. Results In the RA group, more than half (56.7%) had problems with the TMJ, 70% of them had masseter hypertrophy and clicks in the TMJ, and 46.7% had tinnitus (in the control group: 10%, 30%, and 30%, respectively). Patients also had a limited range of abduction movement in the TMJ (38.0 ±6.1 mm). Analysis of the pain map of Prof. Mariano Rocabado in RA patients indicates a significantly greater number of pain structures. In the control group no pain was observed in structures such as the posterosuperior synovial and bilaminar zone, posterior ligament, or retrodiscal area. Conclusions Temporomandibular joint problems in RA patients were more serious than in the control group and these differences were statistically significant for most tests. The awareness of the problem with the TMJ in RA patients is very low; participants of our study were 100% unaware that the function of the TMJ could be improved. Additionally, there are no guidelines for the treatment and rehabilitation of these joints.
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Byun SH, Min C, Choi HG, Hong SJ. Increased Risk of Temporomandibular Joint Disorder in Patients with Rheumatoid Arthritis: A Longitudinal Follow-Up Study. J Clin Med 2020; 9:jcm9093005. [PMID: 32957710 PMCID: PMC7565073 DOI: 10.3390/jcm9093005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/17/2022] Open
Abstract
We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.
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Affiliation(s)
- Soo-Hwan Byun
- Department of Oral & Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang 14068, Korea;
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Hyo-Geun Choi
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea;
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (H.-G.C.); (S.-J.H.); Tel.: +82-10-9033-9224 (H.-G.C.); +82-31-8086-2670 (S.-J.H.)
| | - Seok-Jin Hong
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Dongtan 18450, Korea
- Correspondence: (H.-G.C.); (S.-J.H.); Tel.: +82-10-9033-9224 (H.-G.C.); +82-31-8086-2670 (S.-J.H.)
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Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review. Clin Oral Investig 2018; 23:2475-2488. [DOI: 10.1007/s00784-018-2664-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 09/25/2018] [Indexed: 11/27/2022]
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Andrade KMD, Alfenas BFM, Campos CH, Rodrigues Garcia RCM. Mandibular movements in older people with rheumatoid arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e153-e159. [PMID: 28407990 DOI: 10.1016/j.oooo.2017.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/24/2017] [Accepted: 01/31/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to compare the mandibular movements in older people with and without temporomandibular disorder (TMD) associated with rheumatoid arthritis (RA). STUDY DESIGN Thirty partially or completely edentulous older adults (65.33 ± 4.7 years) were assigned to 2 groups: (1) with RA and TMD and (2) without RA and TMD. Chewing movements of the jaws during mastication of the test material (Optocal) and the range of mandibular movements were evaluated by using the JT-3-D kinesiographic device before and after new removable prosthesis insertion. Multiple comparisons were made with analysis of variance (ANOVA) and the Tukey-Kramer test. RESULTS Comparisons between the 2 groups before and after new prosthesis insertion revealed that the RA and TMD group had reduced opening angles (P < .05) during chewing. After insertion of new prostheses, both groups showed increased opening and closing angles during chewing (P < .05). The mandibular range of motion results showed that patients with RA and TMD exhibited lower aperture and laterality movements (P < .05) compared with controls before and after new prosthesis insertion. However, there was an increase in aperture, lefty laterality, and protrusion values after new prosthesis insertion in both groups. CONCLUSIONS TMD associated with RA may impair mandibular movements. Well-fitted prostheses may improve mandibular movements in older adults, especially those with RA.
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Affiliation(s)
- Kelly Machado de Andrade
- Graduate Student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Bruna Fernandes Moreira Alfenas
- Graduate Student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Camila Heitor Campos
- Assistant Professor, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Rio de Janeiro, Brazil
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Piancino MG, Cannavale R, Dalmasso P, Tonni I, Filipello F, Perillo L, Cattalini M, Meini A. Condylar asymmetry in patients with juvenile idiopathic arthritis: Could it be a sign of a possible temporomandibular joints involvement? Semin Arthritis Rheum 2015; 45:208-13. [DOI: 10.1016/j.semarthrit.2015.04.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/27/2015] [Accepted: 04/27/2015] [Indexed: 11/29/2022]
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