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

Rebeca Cecília Souza, Emerson Tavares de Sousa, David Sousa, Marcelo Sales, Rudyard Dos Santos Oliveira, Maria Helena Mariano, Eliézer Rushansky, Ana Cláudia Amorim Gomes, Emanuel Silva, Rebeca Cecília Souza, Emerson Tavares de Sousa, David Sousa, Marcelo Sales, Rudyard Dos Santos Oliveira, Maria Helena Mariano, Eliézer Rushansky, Ana Cláudia Amorim Gomes, Emanuel Silva

Abstract

Background: 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: chronic pain; quality of life; spondyloarthritis; temporomandibular disorders.

Conflict of interest statement

All authors declare that they have no conflicts of interest for this work.

© 2021 Souza et al.

Figures

Figure 1
Figure 1
Diagnostic distributions of the cases relative to TMJ Group I, II, and III. Group I – Muscle Diagnosis, Group II – Disc displacements on the (right and left) joint, and Group III – Other joint conditions (Arthralgia, osteoarthritis, and osteoarthrosis).

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