The comprehensive evaluation of temporomandibular disorders seen in rheumatoid arthritis

Background: We Studied clinical signs and symptoms of temporomandibular disorders and radiological changes in the temporomandibular joint from patients with rheumatoid arthritis (RA) compared to patients with myofascial pain dysfunction of the temporomandibular system and control patients to evaluate clinical and radiological relationships. Methods: A cross-sectional, controlled, clinical and radiological study was planned and 99 subjects (69 patients and 30 controls) were included in the study. Results: Twenty-three patients with RA (69.7 per cent) had painful temporomandibular joint. Fifty-five per cent had myofascial pain dysfunction according to the research diagnostic criteria for temporomandibular disorders (TMD). Nearly all of our patients with RA (93.9 per cent) had symptoms, and almost all of them had positive findings of TMD in high resolution computed tomography. Condylar head resorption, joint space narrowing and degeneration were statistically more prominent features in patients with rheumatoid arthritis compared with controls (p<0.05). The pain score on active palpation correlated with the number of the mandibular subchondral cysts on high resolution computed tomography (r=0.6, p<0.05). Conclusion: Although the myofascial pain of the temporomandibular system is an important cause of pain in rheumatoid arthritis, prospective controlled studies are needed to develop effective therapeutic strategies for these patients.