Targeted Assessment of the Temporomandibular Joint in Patients With Rheumatoid Arthritis

Bessa-Nogueira, Ricardo V.; Vasconcelos, Belmiro Cavalcanti do Egito; Duarte, Angela P.; Góes, Paulo S.A.; Bezerra, Tácio P.

doi:10.1016/j.joms.2007.08.037

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 9 , Pages 1804-1811, September 2008

Targeted Assessment of the Temporomandibular Joint in Patients With Rheumatoid Arthritis

Ricardo V. Bessa-Nogueira, DDS, MSc
- PhD Student, Oral and Maxillofacial Surgery, University of Pernambuco, Recife, Brazil
Belmiro Cavalcanti do Egito Vasconcelos, PhD
- Senior Lecturer and Director of the MSc and PhD Programs, Oral and Maxillofacial Surgery, University of Pernambuco, Recife, Brazil
- Address correspondence and reprint requests to Dr Vasconcelos: Department of Oral and Maxillofacial Surgery, University of Pernambuco, 1650 Av General Newton Cavalcanti, 54753-220 Recife, PE, Brazil
Angela P. Duarte, MD, PhD
- Senior Lecturer, Department of Rheumatology, Federal University of Pernambuco, Recife, Brazil
Paulo S.A. Góes, DDS, PhD
- Senior Lecturer, Preventive and Social Dentistry, University of Pernambuco, Recife, Brazil
Tácio P. Bezerra, DDS
- Senior Resident, 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.