RESEARCH - Targeted assessment of the temporomandibular joint in patients with RA

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J Oral Maxillofac Surg. 2008 Sep;66(9):1804-11.

Targeted assessment of the temporomandibular joint in patients with

rheumatoid arthritis.

Bessa-Nogueira RV, Vasconcelos BC, Duarte AP, Góes PS, Bezerra TP.

Oral and Maxillofacial Surgery, University of Pernambuco, Recife, Brazil.

PURPOSE: This observational study was done to identify the signs and

symptoms of temporomandibular joint (TMJ) involvement in patients with

rheumatoid arthritis (RA) and to assess the association between these

and quantitative measurements for the evaluation of rheumatologic

disease. PATIENTS AND METHODS: The sample comprised 61 patients

suffering from RA whose signs and symptoms of TMJ were recorded by

means of a questionnaire (scale of limited mandibular function) and

clinical measurements (pain during jaw movement, limitation of maximal

mouth opening, joint sounds, tenderness on TMJ palpation, tenderness

on masticatory muscle palpation). These findings were correlated with

the quantitative measurements for evaluating RA: duration of the

disease, positivity for rheumatoid factor, Health Assessment

Questionnaire (HAQ) score, number of edematous and painful joints, and

overall assessment of functional status. RESULTS: In terms of overall

figures, 70.5% of the patients presented with at least 1 sign or

symptom, 49.2% had at least 1 symptom, and 54.1% had at least 1 sign.

The variable pain on movement was associated with the number of

painful joints and the overall assessment findings (P < .05). Sound on

movement was positively associated with the number of edematous joints

(P = .0291). The scale of limited mandibular function was

statistically significantly correlated with 4 quantitative

measurements (P = .0283 to .0448). The variable pain on palpation of

the masticatory muscles was associated with the number of painful

joints (P = .0023). Pain on palpation of the TMJ was statistically

significantly associated with the HAQ score (P = .0344) and with the

number of painful joints (P = .0006).

CONCLUSION: A significant percentage of the patients with RA have

signs and symptoms of TMJ involvement, and the scale of limited

mandibular function proved to be an important measurement tool.

PMID: 18718386

http://www.ncbi.nlm.nih.gov/pubmed/18718386

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