慢性関節リウマチと顎関節-その病変とX線所見

概要

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One hundred and nine patients aged 21 to 76 with rheumatoid arthritis were investigated for the incidence of the temporomandibular joint (TMJ) involvement clinically and radiographic changes. Sixty-eight (62.4%) out of 109 patients had experienced TMJ symptoms at some time during course of their disease. This figure agrees nearly with other recent studies. The range of opening mouth in patients with TMJ involvement was not reduced significantly compared to that in patients without TMJ involvement. The high incidence of TMJ involvement seemed to be related to the positive RA factor, early onset of RA, long disease duration and acute polyarticular type of RA. Joint noise (crepitus), pain and limitation of jaw movement were the main clinical symptoms. It is likely that the progressive anterior open bite and chin posterior positioned were characteristic features of TMJ with RA. Radiographically, the surface erosion and flattening of TMJ condyle were frequently observed. No evidence of bony ankylosis in TMJ were found. In the severe case, the condyle was erode out and under subluxation. The longer disease duration, the severer radiographic changes were found.