Temporomandibular disorders in rheumatoid arthritis

Objective. To determine the frequency and character of temporomandibular di sorders (TMD) in Oriental patients with rheumatoid arthritis (RA) and to in vestigate the relationship between TMD and RA in a tertiary referral center . Methods. Symptoms and signs related to TMD were investigated in 80 patients (67 female, 13 male) who fulfilled the American College of Rheumatology 19 87 revised criteria for RA. Diagnoses of TMD including muscle, disk displac ement, or temporomandibular joint (TMJ) disorders were made based on clinic al assessment. TMJ disorder was then correlated with the clinical, laborato ry, and radiological features of RA. Results, The mean age of the study population was 49.7 years and the mean d uration of RA was 86.9 months. Eleven patients (13.8%) had active RA at the time of TMD assessment. About 76% of the study population had seropositive disease and 62% had peripheral joint erosions. Osteoarthrosis of the TMJ w as the most common TMD in this Oriental population. Joint sounds on opening (35%), joint sounds on moving sideways or forward (27.5%), and pain in jaw joints (23.7%) were common TMD symptoms. Deviated mouth opening (45%) and coarse crepitus (15-21.3%) were most prevalent on examination. Conclusion. Patients with RA who had prolonged disease duration of RA and a ctive peripheral joints tended to have osteoarthrosis of the TMJ. Presence of rheumatoid factor or peripheral joint erosions was not associated with T MJ osteoarthrosis.