Prevalence of Temporomandibular Joint Disorders in Patients with Ankylosing Spondylitis: A Cross-Sectional Study

Abstract

Rebeca Cecília Souza,1 Emerson Tavares de Sousa,2 David Sousa,3 Marcelo Sales,4 Rudyard dos Santos Oliveira,5 Maria Helena Mariano,6 Eliézer Rushansky,7 Ana Cláudia Amorim Gomes,8 Emanuel Silva8 1Department of Oral Surgery, Dental School, Pernambuco University, Recife, Pernambuco, Brazil; 2Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; 3Center of Medical Sciences, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil; 4Department of Clinical and Community Dentistry, Dental School, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil; 5Department of Orthodontics, Sao Leopoldo Mandic School, Campinas, São Paulo, Brazil; 6Department of Rheumatology, Oswaldo Cruz University Hospital, Medical School, Pernambuco University, Recife, Pernambuco, Brazil; 7Brazilian Society of Rheumatology, Department of Rheumatology, Oswaldo Cruz University Hospital, Medical School, Pernambuco University, Recife, Pernambuco, Brazil; 8Department of Oral and Maxillofacial Surgery, Oswaldo Cruz University Hospital, Dental School, Pernambuco University, Recife, Pernambuco, BrazilCorrespondence: Emanuel SilvaUniversity of Pernambuco, School of Dentistry, Oswaldo Cruz University Hospital, Department of Oral and Maxillofacial Surgery, 310 Arnóbio Marquês Street, Recife, PE, 50100-130, BrazilTel [phone]Email [email protected]: This study sought to investigate which temporomandibular disorders (TMD) can be expected in patients with ankylosing spondylitis (AS) and to determine the combined impact of these conditions on the psychological status, chronic pain, and functional disability.Material and Methods: A cross-sectional study composed of 30 patients between 18 and 65 years with ankylosing spondylitis was performed. The research protocol considered the evaluation of outcomes related to the ankylosing spondylitis (HLA-B27 antigen, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire – Spondylitis (HAQ-S)) and temporomandibular disorders (axis I and II of the Research Diagnostic Criteria for Temporomandibular Disorders – RDC/TMD). Descriptive analyses were applied to express the results.Results: The sample presented both AS and TMD, most of them (24) were diagnosed with conventional AS (HLA-B27 positive). The BASDAI was scored as 7.70 (2.30) (high activity of AS disease). Functional disability represented by high scores of BASFI [7.00 (2.63)] and HAQ-S [1.79 (0.62)] demonstrates the severe impact of the disease on the daily routine and quality of life. According to RDC/TMD diagnostic criteria, 17 (57%) share the three groups of TMD, and 9 (30%) share two groups of TMD (Group I and III). Over 73% of the volunteers scored high levels of chronic pain (Grade III and IV) associated with a high depression scale score. The sample scored the somatization scale (with and without pain) as severe.Conclusion: Patients with ankylosing spondylitis presented a high prevalence of temporomandibular disorder, most of them having the degenerative forms of TMJ disease. AS and TMD cause moderate to severe chronic pain and a negative impact on psychological status and functional capacities.Keywords: spondyloarthritis, temporomandibular disorders, quality of life, chronic pain

Keywords

• spondyloarthritis. temporomandibular disorders. quality of life. chronic pain.