The effect of methotrexate on the temporomandibular joint in polyarticularjuvenile rheumatoid arthritis patients

Temporomandibular joint (TMJ) arthropathy is common in juvenile rheumatoid arthritis (JRA) patients and can cause functional and esthetic problems. Th e purpose of this pilot study was to begin to evaluate whether methotrexate (MTX) therapy can reduce TMJ arthropathy in patients with polyarticular JR A. There were 27 patients with polyarticular JRA studied. Of these, 18 were re ceiving MTX and non-steroidal anti-inflammatory drugs and 9 were receiving just non-steroidal anti-inflammatory drugs. A routine physical examination, including a detailed joint evaluation, was performed by their rheumatologi st. A craniofacial examination was performed by the orthodontist and includ ed a radiographic TMJ evaluation (panoral and corrected axial tomograms). Radiographic evidence of condylar degeneration was apparent in 83% of all p olyarticular JRA patients. The patients receiving MTX showed less severe TM J involvement than those not receiving MTX.