title: Bilateral asymptomatic fibrous-ankylosis of the temporomandibular joint associated with rheumatoid arthritis: a case report.
abstract: The American Academy of Orofacial Pain (AAOP) defines ankylosis of the temporomandibular joint (TMJ) as a restriction of movements due to intracapsular fibrous adhesions, fibrous changes in capsular ligaments (fibrous-ankylosis) and osseous mass formation resulting in the fusion of the articular components (osseous-ankylosis). The clinical features of the fibrous-ankylosis are severely limited mouth-opening capacity (limited range of motion during the opening), usually no pain and no joint sounds, marked deflection to the affected side and marked limitation of movement to the contralateral side. A variety of factors may cause TMJ ankylosis, such as trauma, local and systemic inflammatory conditions, neoplasms and TMJ infection. Rheumatoid arthritis (RA) is one of the systemic inflammatory conditions that affect the TMJ and can cause ankylosis. The aim of this study is to present a case of a female patient diagnosed with bilateral asymptomatic fibrous-ankylosis of the TMJ associated with asymptomatic rheumatoid arthritis. This case illustrates the importance of a comprehensive clinical examination and correct diagnosis of an unusual condition causing severe mouth opening limitation.
authors: Department of Prosthodontics, Bauru Dental School, USP - University of São Paulo, Bauru, SP, Brazil. carol.ortigosa@gmail.com
authors: Carolina Ortigosa
authors: CO
authors: Cunha
authors: Lívia Maria Sales
authors: LM
authors: Pinto
authors: Luana Menezes
authors: LM
authors: de Mendonça
authors: Aline Dantas Diógenes
authors: AD
authors: Saldanha
authors: Ana Cláudia de Castro Ferreira
authors: AC
authors: Conti
authors: Paulo César Rodrigues
authors: PC
authors: Conti
mesh_terms: D000844:Ankylosis / Q000175:diagnosis*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D058070:Asymptomatic Diseases; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D005355:Fibrosis; D006801:Humans; D017746:Joint Capsule / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008335:Mandibular Condyle / Q000473:pathology; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D013701:Temporal Bone / Q000473:pathology; D013704:Temporomandibular Joint / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D000267:Tissue Adhesions / Q000175:diagnosis