title: Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data.
abstract: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questionnaire was used for clinical evaluation of the TMJ and for TMD classification of 49 patients of both sexes and all ages. Individuals who had already undergone prior treatment for TMD and/or with a history of craniofacial trauma were excluded. The participants underwent cone beam computed tomography (CBCT) exams to assess possible degenerative changes in the mandibular condyle and the articular eminence. The frequencies of the changes found are presented and the possible associations between clinical and CT findings analyzed using the chisquare test. It was found that 75% of the patients had complaints of pain in the orofacial region, including arthralgia, myalgia or both. As for the diagnoses, 100% of the sample was diagnosed as RDC/TMD Group III (arthralgia, osteoarthritis or osteoarthrosis). The presence of degenerative bone changes was found in 90% of the subjects, the most prevalent being flattening (78.7%) and osteophytes (39.3%). The association test suggested a greater tendency to develop degenerative changes in asymptomatic individuals (p = 0.01). The asymptomatic nature of the involvement of the TMJ in RA can hide structural damage seen in imaging. Thus, the importance of early diagnosis and treatment to reduce structural and functional damage is emphasized.
authors.affiliation: School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. patricia.cataldo@hotmail.com.
authors.forename: Patrícia Cf
authors.initials: PC
authors.lastname: Cordeiro
authors.affiliation: School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Josemar P
authors.initials: JP
authors.lastname: Guimaraes
authors.affiliation: School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Viviane A
authors.initials: VA
authors.lastname: de Souza
authors.affiliation: School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Dias
authors.affiliation: School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Jesca Nn
authors.initials: JN
authors.lastname: Silva
authors.affiliation: School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Karina L
authors.initials: KL
authors.lastname: Devito
authors.affiliation: Estácio Juiz de Fora University, Juiz de Fora, Minais Gerais, Brazil.
authors.forename: Leticia L
authors.initials: LL
authors.lastname: Bonato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle; D008875:Middle Aged; D010003:Osteoarthritis; D013704:Temporomandibular Joint / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D055815:Young Adult
keywords: cone beam computed tomography; rheumatoid arthritis; temporomandibular disorder; temporomandibular joint