Alteraciones temporomandibulares y odontológicas en pacientes con artritis reumatoide / Temporomandibular and odontological abnormalities in patients with rheumatoid arthritis

OBJETIVO: Caracterizar las afecciones orofaciales en pacientes con artritis reumatoide (AR) y compararlas con las presentes en pacientes sin la enfermedad de la ciudad de Chihuahua, Chihuahua, México. MÉTODOS: El estudio incluyó a 30 pacientes con diagnóstico de AR y 30 pacientes consecutivos en una consulta de odontología. A través de una revisión clínica odontológica, se compararon entre los grupos variables relacionadas con: 1) trastornos clínicos y radiográficos de la articulación temporomandibular, 2) análisis biomecánico craneocervical, 3) estado de la dentición y necesidades de tratamiento, 4) estado periodontal, 5) estado de higiene oral y 6) dolor facial. Además se determinó la asociación entre las variables estudiadas a través de pruebas de correlación. RESULTADOS: Los pacientes con AR tuvieron una mayor prevalencia de alteraciones en la articulación temporomandibular, tanto clínicas (100 vs. 60%; p < 0,001) como radiográficas incluyendo erosiones (50 vs. 16; p = 0,010), en comparación con la población de referencia. Además los pacientes con AR tuvieron mayor cantidad de pérdidas dentales (6,9±5,7 vs. 3±2; p = 0,001), caries (13,4±5,4 vs. 4,9±6,5; p = 0,001), periodontitis (1,3±0,9 vs. 0,8±0,8; p = 0,015), higiene oral deficiente (43,3 vs. 13,3%; p = 0,005) y más dolor facial (66,7 vs. 20%; p < 0,001). El análisis de cefalometría de Rocabado mostró diferencias en el ángulo craneocervical y triángulo hioideo entre AR y controles. Se obtuvieron correlaciones significativas entre las alteraciones orales y las temporomandibulares. CONCLUSIONES: Los pacientes con AR mostraron un mayor deterioro orofacial, lo que refleja la importancia de atención multidisciplinaria incluyendo la evaluación odontológica periódica

OBJECTIVE: To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS: The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS: Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS: Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination

Temporomandibular and Odontological Abnormalities in Patients with Rheumatoid Arthritis. / Alteraciones temporomandibulares y odontológicas en pacientes con artritis reumatoide.

OBJECTIVE: To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS: The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS: Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS: Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination.