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Correlation between TM joint disease and rheumatic diseases detected on bone scintigraphy and clinical factors. Sci Rep 2020; 10:4547. [PMID: 32161274 PMCID: PMC7066130 DOI: 10.1038/s41598-020-60804-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 02/17/2020] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to evaluate the effect of rheumatic disease as a risk factor for temporomandibular disease (TMD). A total of 143 outpatients reporting symptoms indicating rheumatic disease at their first visit to the rheumatology clinic were included. We evaluated the temporomandibular joint (TMJ) with scintigraphic images, and standard questionnaires were administered for the symptomatic assessment for all patients. The patients were classified into ‘healthy controls’ or as per their diagnosis into ‘osteoarthritis’, ‘axial spondyloarthritis’, ‘peripheral spondyloarthritis’, ‘rheumatoid arthritis’, or ‘other rheumatic diseases’ groups. The patients were also differentiated depending on the presence or absence of axial involvement. The relation between the rheumatic disease type and findings at the TMJ were evaluated using statistical analyses. Axial spondyloarthritis, peripheral spondyloarthritis, and rheumatic arthritis patients showed significantly higher scintigraphic uptake at the TMJ compared with those in the control and osteoarthritis groups (axial spondyloarthritis: 4.5, peripheral spondyloarthritis: 4.5, rheumatoid arthritis: 4.09, control: 3.5, osteoarthritis: 3.4, p < 0.0001). Compared with patients without axial involvement, patients with axial involvement also showed significantly higher TMJ scintigraphic uptake (axial involvement: 4.24, without axial involvement: 3.50, p < 0.0001) with elevated symptomatic rates in TMD (axial involvement: 17.82, without axial involvement: 9.97, p < 0.005).
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González-Chávez SA, Pacheco-Tena C, Campos Torres RM, Quiñonez-Flores CM, Reyes-Cordero G, Caraveo Frescas TDJ. Temporomandibular and Odontological Abnormalities in Patients with Rheumatoid Arthritis. ACTA ACUST UNITED AC 2018; 16:262-271. [PMID: 30097330 DOI: 10.1016/j.reuma.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/20/2018] [Accepted: 07/06/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination.
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Affiliation(s)
| | - César Pacheco-Tena
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México.
| | - Rosa María Campos Torres
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México; Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
| | | | - Greta Reyes-Cordero
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
| | - Teresita de Jesús Caraveo Frescas
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México; Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
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Rehan OM, Saleh HAK, Raffat HA, Abu-Taleb NS. Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam computed tomography study. Imaging Sci Dent 2018; 48:1-9. [PMID: 29581944 PMCID: PMC5863014 DOI: 10.5624/isd.2018.48.1.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 01/09/2018] [Accepted: 01/24/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate osseous changes of temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA) using cone-beam computed tomography (CBCT) and to correlate the imaging findings with the severity of TMJ dysfunction, clinical findings, and laboratory findings. Materials and Methods This study consisted of 28 subjects, including 14 RA patients and 14 controls, who were scheduled to undergo CBCT imaging for the diagnosis of a complaint not related to or affecting the TMJ. The Fonseca's questionnaire was used to assess the severity of TMJ dysfunction. Rheumatoid factor (RF) and the erythrocyte sedimentation rate (ESR) were assessed in the RA patients. CBCT was then performed in all subjects and osseous TMJ abnormalities were assessed. Results According to the Fonseca's questionnaire, 14.3% of the patients had no TMJ dysfunction, while 50%, 21.4%, and 14.3% had mild, moderate, and severe dysfunction, respectively. RF was positive in 64.3% of patients, and the ESR level was high in 100%. Imaging findings revealed a statistically significantly higher prevalence of erosion (85.7%), flattening (89.3%), osteophyte formation (32.1%), subchondral cyst (32.1%), sclerosis (64.3%), and condylar irregularities (28.6%) in the RA patients than in the controls. No correlations were found between CBCT findings and the clinical findings, the severity of TMJ dysfunction, disease duration, or laboratory results. Conclusion RA patients might show extensive osseous abnormalities with no/mild clinical signs or symptoms of TMJ dysfunction that necessitate TMJ imaging for these patients. CBCT is a valuable and efficient modality that can assess osseous TMJ changes in RA patients.
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Affiliation(s)
- Ola Mohamed Rehan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hoda Abdel Kader Saleh
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hala Ahmed Raffat
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Saleh Abu-Taleb
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Al Moaleem MM, Okshah AS, Al-Shahrani AA, Alshadidi AAF, Shaabi FI, Mobark AH, Mattoo KA. Prevalence and Severity of Temporomandibular Disorders among Undergraduate Medical Students in Association with Khat Chewing. J Contemp Dent Pract 2017; 18:23-28. [PMID: 28050980 DOI: 10.5005/jp-journals-10024-1982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The aim of this study was to assess the prevalence and severity of temporomandibular joint disorders (TMDs) among undergraduate medical students in the presence of khat chewing over a period of time. MATERIALS AND METHODS Totally, 186 medical college students (age < 20 years) were randomly selected for the present study. The study subjects were divided into two groups according to age, under 20 and above 20 years. The study was based on Fonseca's anamnestic index and its questionnaire, which is composed of 10 questions and classifies the severity of TMDs. The obtained data were coded and entered into Statistical Package for the Social Sciences (SPSS) program for analysis using chi-square test at significance level of 5%. RESULTS Most of the participants were male (68.8%) students and older than 20 years (63%). Those who reported with khat chewing comprised 31.7%. From the total samples, only 38.0% was classified as having mild TMD and 0.50% were classified as having severe TMD. Poor dental articulation, grinding of teeth, headaches, tense personalities, and temporomandibular joint (TMJ) clicking were the most common clinical findings. The mean scores showed no significant difference among gender (p < 0.29) and the khat chewing (p < 0.531) groups for the 10 questions. However, it showed significant difference among age groups (p < 0.025). CONCLUSION The majority of subjects complained of mild TMD, while only a few cases showed a moderate TMD among different age groups. The most frequently reported dysfunctions were related to poor dental articulation and grinding of the teeth, frequent headaches, the clicking of joint, and tense personalities. No significant difference was found between gender and khat and nonkhat chewing groups. CLINICAL SIGNIFICANCE Khat chewing is a parafunctional habit and affects dental occlusion (especially cuspal wear) in terms of anterior guidance. Such alterations in occlusion are known to be one of the causative (predisposing) factors of TMD.
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Affiliation(s)
- Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry Jazan University, Jazan, Kingdom of Saudi Arabia, e-mail:
| | - Abdulmajeed S Okshah
- Department of Prosthodontics, Bernhard-Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna Austria Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Ahid A Al-Shahrani
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Kingdom of Saudi Arabia Department of Prosthodontics, Indiana University-Purdue University Indianapolis, Indiana, USA
| | - Abdulkhaliq Ali F Alshadidi
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Fawzia I Shaabi
- Saudi Board, King Abdulaziz University Training Center Jeddah, Kingdom of Saudi Arabia
| | | | - Khurshid A Mattoo
- Department of Prosthetic Dental Science, College of Dentistry Jazan University, Jazan, Kingdom of Saudi Arabia
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Habib SR, Al Rifaiy MQ, Awan KH, Alsaif A, Alshalan A, Altokais Y. Prevalence and severity of temporomandibular disorders among university students in Riyadh. Saudi Dent J 2015; 27:125-30. [PMID: 26236125 PMCID: PMC4501441 DOI: 10.1016/j.sdentj.2014.11.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/11/2014] [Accepted: 11/19/2014] [Indexed: 01/11/2023] Open
Abstract
Objective The aim of this study was to evaluate the prevalence and severity of temporomandibular disorders (TMDs) among male university students in Riyadh, Saudi Arabia. The role of relevant medical and dental histories in the assessment of TMD in this Arab population was also addressed. Methods Required information was collected via a questionnaire. The first part of the questionnaire was used to obtain the medical and dental histories of participants. The second part included 10 questions regarding common TMD symptoms. Fonseca’s anamnestic index (FAI) was used to classify TMD severity as “no dysfunction”, “light dysfunction”, “moderate dysfunction”, or “severe dysfunction”. Results Of the 600 distributed questionnaires, 400 questionnaires were completed (response rate: 66.6%). Mean age of eligible participants was 21.90 ± 1.79 years. Psychological stress (30.5%) and direct restorations (77%) were the most commonly reported items on the medical and dental histories respectively for the total number of participants. According to the FAI, 53.2% of participants were classified as having no dysfunction, followed by light (36.1%), moderate (9.6%), and severe dysfunction (1.1%). Conclusions Based on the FAI, mild to moderate prevalence of TMD appears to exist among male university students in Riyadh. Histories of psychological stress and dental treatment were evident among these students. Information obtained from the FAI may be helpful in assessing the prevalence of TMD and has important implications for the early diagnosis of TMD and the prevention of future TMD-related complications.
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Affiliation(s)
- Syed Rashid Habib
- Dept. of Prosthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Corresponding author at: Dept. of Prosthetic Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, King Abdullah Road, Riyadh 11545, Saudi Arabia. Tel.: +966 1 467 7441 (O), +966 534750834 (mobile); fax: +966 1 467 8548.
| | | | - Kamran Habib Awan
- Dept. of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alsaif
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Yasser Altokais
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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