Sicca symptoms, and lacrimal and salivary flow in Albanian patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis affects primarily the synovial joints, but is often accompanied by extra-articular manifestations, including lacrimal and salivary gland involvement. The aim of the present study was to estimate the prevalence of ocular and oral sicca symptoms and reduced lacrimal and salivary flow in rheumatoid arthritis and the relation between sicca symptoms and objective measures of lacrimal and salivary flow. METHODS: We examined 88 consecutive hospitalized patients with rheumatoid arthritis and 88 age- and gender-matched healthy controls. The examination included the standardized questionnaire for keratoconjunctivitis sicca and xerostomia which forms part of the European criteria for Sjögren's syndrome, the Schirmer's I test and measurement of unstimulated whole salivary flow rate. RESULTS: A significantly higher proportion of patients (40.9%) reported ocular sicca symptoms than healthy matched controls (8.0%). Further, a significantly higher proportion of patients (44.3%) reported oral sicca symptoms compared to controls (13.6%). 48.9% of the patients had low Schirmer I score, compared to 20.5% of controls. Reduced salivary flow was found in 27.3% of patients, compared to 9.1% of controls. The differences in lacrimal and salivary flow between patient and control group were statistically significant. The minimum prevalence of secondary Sjögren's syndrome was 14.8%. Weak association was observed between sicca symptoms and the objective measures of lacrimal and salivary flow in patients, and no association was detected in control subjects. CONCLUSIONS: Sicca symptoms and reduced lacrimal and salivary flow were common manifestations in rheumatoid arthritis and should be given adequate consideration during management of patients with rheumatoid arthritis.

Unilateral temporomandibular disorder and asymmetry of occlusal contacts.

STATEMENT OF PROBLEM: The relationship between temporomandibular disorders and occlusal tooth contacts is unclear and controversial. PURPOSE: This study assessed whether unilateral temporomandibular disorders were associated with the absence of bilateral symmetry in the number of occlusal contacts. MATERIAL AND METHODS: Fifteen university dental students who had complete natural dentition and normal occlusion and exhibited unilateral signs and symptoms of temporomandibular disorders were compared to 15 age- and sex-matched healthy control subjects. All participants met specific inclusion and exclusion criteria. Occlusal contacts were recorded in the intercuspal position with wax registrations. Dental impressions were made and poured in type I stone. Contacts were classified according to location and intensity. Four experienced dentists using an established protocol made all measurements. Assessment of the reliability of the occlusal registration procedure showed a small (<4%) within-subject variability. Statistical analysis was based on the binomial distribution and nonparametric tests (P < .05). RESULTS: Subjects with unilateral temporomandibular disorders had greater bilateral difference in the number of contacts than controls. The median (95% confidence interval) difference was 3 (2 to 4) and 2 (1 to 2), respectively. In unilateral temporomandibular disorder subjects, the number of occlusal contacts was greater on the side with, rather than without, disorder (median number 20 vs. 16). The median (95% confidence interval) difference between sides with and without unilateral temporomandibular disorders was 3 (2 to 4) for all contacts and 2 (1 to 3) for contacts on the posterior teeth. CONCLUSION: Within the population of this study, a weak association was found between unilateral temporomandibular disorders and asymmetry in the number of occlusal contacts.