Clinical and CT Scan Evaluation of Temporomandibular Joints with Osteoarthritis and Rheumatoid Arthritis

Deoghare, Abhijeet; Degwekar, Shirish

doi:10.5005/jp-journals-10011-1058

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…Morning stiffness, mandibular deviation, and limitation of mouth opening occurred less frequently (21.4%, 14.3%, and 14.3%, respectively), and swelling was the least frequent clinical finding (7.1%). Our results are consistent with those of Helenius et al 27 and Ozcan et al, 28 who found that clicking was the most frequent clinical symptom; in contrast, Deoghare and Degwekar 18 and Ardic et al 12 reported that the most common clinical findings were joint tenderness and pain, respectively.…”

Section: Discussionsupporting

confidence: 92%

“…These results are similar to those of Goupille et al 19 who detected cortical erosion in both controls and RA patients, with frequencies of 57.6% and 88.4%, respectively. Similarly, Deoghare and Degwekar 18 and Hajati et al 20 detected erosion in 85% and 72% of patients, respectively. However, lower frequencies of erosion were detected by Bayar et al, 17 Voog et al, 16 and Gheita et al 14 in their RA patients (13.3%, 50%, and 62.5%, respectively).…”

Section: Discussionmentioning

confidence: 80%

“…Many studies have been conducted to investigate the ability of CT to detect osseous involvement of the TMJ in RA patients; these studies revealed that CT was highly accurate for detecting degenerative changes in the TMJ. 14 16 17 18 19 CBCT has been used to assess TMJ condylar resorption, which occurs in early RA patients. 20 …”

Section: Introductionmentioning

confidence: 99%

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Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam computed tomography study

et al. 2018

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PurposeTo evaluate osseous changes of temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA) using cone-beam computed tomography (CBCT) and to correlate the imaging findings with the severity of TMJ dysfunction, clinical findings, and laboratory findings.Materials and MethodsThis study consisted of 28 subjects, including 14 RA patients and 14 controls, who were scheduled to undergo CBCT imaging for the diagnosis of a complaint not related to or affecting the TMJ. The Fonseca's questionnaire was used to assess the severity of TMJ dysfunction. Rheumatoid factor (RF) and the erythrocyte sedimentation rate (ESR) were assessed in the RA patients. CBCT was then performed in all subjects and osseous TMJ abnormalities were assessed.ResultsAccording to the Fonseca's questionnaire, 14.3% of the patients had no TMJ dysfunction, while 50%, 21.4%, and 14.3% had mild, moderate, and severe dysfunction, respectively. RF was positive in 64.3% of patients, and the ESR level was high in 100%. Imaging findings revealed a statistically significantly higher prevalence of erosion (85.7%), flattening (89.3%), osteophyte formation (32.1%), subchondral cyst (32.1%), sclerosis (64.3%), and condylar irregularities (28.6%) in the RA patients than in the controls. No correlations were found between CBCT findings and the clinical findings, the severity of TMJ dysfunction, disease duration, or laboratory results.ConclusionRA patients might show extensive osseous abnormalities with no/mild clinical signs or symptoms of TMJ dysfunction that necessitate TMJ imaging for these patients. CBCT is a valuable and efficient modality that can assess osseous TMJ changes in RA patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 80%

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Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam computed tomography study

et al. 2018

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“…In conventional radiographs, TMJ imaging is very challenging because the bony components are small and superimposition from the base of the skull often results in a lack of clear delineation of the joint. [1,7] The appearance of mandibular condyle varies greatly among different age groups and individuals. Mandibular condyle may be categorized into five basic types, flattened, convex, angled, rounded, and concave.…”

Section: Discussionmentioning

confidence: 99%

“…It can cause painful symptoms of joint and surrounding structures and cause destruction of the temporomandibular articular surfaces if not evaluated and treated in time. [7] The primary assessment of TMD is based on a clinical examination of the TMJ and masticatory system. However, clinical diagnoses are unreliable with respect to the status of the TMJ.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the detection of simulated condylar lesions on panoramic radiography and cone-beam computed tomography

Mani¹,

Raghavan²,

Birur³

et al. 2018

JCRI

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Background: Degenerative temporomandibular joint (TMJ) disease is characterized by destruction of the articular surface of mandibular condyle. Aims and Objectives: The aim of the present study was to assess the smallest lesion on mandibular condyle that could be detected on panoramic radiograph compared to conebeam computed tomography (CBCT). Materials and Methods: A total of 15 dry human mandibles were included in the study. Three surgical carbide drill bits of diameters 1.8 mm, 2.3 mm, and 4.5 mm length were used to drill holes on anterior, posterior, lateral, medial, and superior surfaces of the condyles. Panoramic and CBCT images were obtained and evaluated by two observers to detect lesions. Interobserver variability was obtained by the application of Cohen's kappa coefficient statistical measure. Results: On panoramic images, kappa value showed fair (0.324), moderate (0.537), and substantial agreement (0.667) for small, shallow, and deeper lesion on condyle, respectively. 16.6% of small, 43.3% of shallow, and 46.3% of deeper lesions were visualized on panoramic images compared to CBCT images. These lesions were predominantly on the superior surface of the condyle. Conclusion: Panoramic radiography can be used to detect lesions on the superior surface of the condyle of more than 2.3 mm diameter or more than 4.5 mm depth. Additional imaging modality such as CBCT is recommended for TMJ degenerative disorders.

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Response of the temporomandibular joint tissue of rats to rheumatoid arthritis induction methods

Wang

Yang

Hsu

et al. 2017

Journal of Dental Sciences

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Background/purpose The pathogenesis of rheumatoid arthritis (RA)-related temporomandibular joint (TMJ) disorder remains unclear. Studies have reported the change of the TMJ after complete Freund's adjuvant (CFA) injection, which is consistent with osteoarthritis. However, few studies have reported that the tissue response of the TMJ in collagen-induced arthritis (CIA) can mimic RA. The present study was aimed to investigate the TMJ response in rat models by CFA-induced arthritis and CIA to verify the proper RA-related TMJ arthritis rat model. Materials and methods In total, 24 rats were randomly divided into four groups: (1) control group; (2) type I collagen injection group; (3) CFA-induced arthritis group; and (4) CIA group. Drugs were injected on Day 0, and the rats were sacrificed on Days 7 and 35. Next, TMJ tissue was collected for hematoxylin and eosin staining, and inflammatory gene ( IL-1β and MMP3 ) expression was investigated. Results Compared with the control group, the type I collagen injection group confirmed the negative inflammatory response through hematoxylin and eosin staining and IL-1βand MMP3 expression. Although CFA-induced arthritis and CIA groups showed inflammatory response (P < 0.05) compared with the control group, histological changes were different. The 7-day CFA-induced arthritis group showed adaptive changes and partly recovered after 35 days of induction. In contrast, 7- and 35-day CIA groups underwent a degenerative process. Conclusion Considering the study limitations, the CIA method is a proper method to study the mechanism of RA-related TMJ arthritis.

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Clinical and CT Scan Evaluation of Temporomandibular Joints with Osteoarthritis and Rheumatoid Arthritis

Cited by 7 publications

References 15 publications

Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam computed tomography study

Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam computed tomography study

Accuracy of the detection of simulated condylar lesions on panoramic radiography and cone-beam computed tomography

Response of the temporomandibular joint tissue of rats to rheumatoid arthritis induction methods

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