Craniomandibular disorders in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: A clinical study

Könönen, Mauno; Wenneberg, Bengt; Kallenberg, A

doi:10.3109/00016359209012774

Cited by 53 publications

(43 citation statements)

References 17 publications

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“…The most frequent clinical features are TMJ sounds, tenderness of the masticatory musculature (particularly, the lateral pterygoid muscles), hypertrophy of the masseters, and limitation of movement manifested as restricted mouth opening. These symptoms and signs are seen less often and are not as severe as those encountered in RA and PA (7). There have been 12 case reports of TMJ ankylosis in patients with AS, 5 of which were bilateral (21).…”

Section: Ankylosing Spondylitis Of the Temporomandibular Jointmentioning

confidence: 99%

“…As a synovial joint, patients with RA are at risk of TMJ involvement, and 67-71% patients will have at least one symptom; however, the true prevalence depends on the population studied, diagnostic criteria, and means of TMJ assessment (1,2,7). The likelihood of TMJ involvement correlates with the severity and duration of the systemic disease as tenderness in multiple peripheral joints is often accompanied by a painful TMJ (2,8,9).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

“…Crepitus, in particular, is considered to be an important sign of joint destruction (1,7). Typical radiographic changes include cortical erosions, subcortical cysts, flattening of the condylar head and articular eminence, subcortical sclerosis, and narrowing of the joint space, but none of these are pathognomonic of RA (8,10,11).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

“…Rheumatoid arthritis patients tend to have more frequent and severe symptoms, signs, and radiographic changes when compared with PA and AS (1,7,10). Crepitus, in particular, is considered to be an important sign of joint destruction (1,7).…”

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

See 3 more Smart Citations

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

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IntroductionThe incidence of temporomandibular joint (TMJ) involvement in inflammatory arthritis is often underestimated, and experience in treatment among rheumatologists is limited. Three conditions have an affinity toward the TMJ: Rheumatoid arthritis (RA), psoriatic arthritis (PA), and ankylosing spondylitis (AS). The prevalence is the highest in RA, followed by PA (1-5).The disease processes differ from those seen in osteoarthritis or following trauma, which are characterized by degeneration or ankylosis, respectively, as joint destruction occurs. Furthermore, inflammatory arthropathies are systemic diseases that can lead to a relapse in symptoms, despite initially successful treatment, as TMJ inflammation continues. Immunosuppressive therapies used to ameliorate systemic inflammation may also complicate treatment responses, particularly if surgical management is required, as there is a theoretical increased risk of infection. In contrast, osteoarthritis symptoms may stabilize, previous joint trauma tends not to deteriorate unless TMJ ankylosis ensues, and immunosuppression is not required. Therefore, a different management approach is required in patients with inflammatory arthropathy that addresses both the systemic illness and localized TMJ disease.Pain, reduced mouth opening, joint noises, locking, and difficulty eating are the predominant symptoms and can be debilitating if left untreated. Pain originates from the TMJ itself, the associated masticatory muscles, or from both these areas, and it is manifested by tenderness on palpation of the respective anatomical area. Mouth opening is measured as the gap between the tips of the upper and lower incisors at maximal opening (interincisal distance) with less than 35 mm considered abnormal (6). Joint noises and locking result from the internal derangement of the joint mechanism, which consists of the mandibular condyle, intra-articular disc, and glenoid fossa, or from inflammatory debris deposited as part of the disease process. Combined with pain and restricted opening, these contribute toward problems in eating. 151Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged in...

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Section: Ankylosing Spondylitis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

Section: Rheumatoid Arthritis Of the Temporomandibular Jointmentioning

confidence: 99%

See 2 more Smart Citations

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

View full text Add to dashboard Cite

show abstract

“…7) The temporomandibular joint (TMJ) also can be influenced by RA with morbidity rates varying from 5% to 86%, according to the study population, diagnostic criteria and evaluation methods. [8][9][10] Patients with TMJ affected by RA show various signs and symptoms such as bilateral pain, tenderness to palpation and limitation of jaw opening. 11) Behavioral factors such as parafunctional habits play a role in causing and perpetuating TMJ disorders.…”

Section: Introductionmentioning

confidence: 99%