Yi-Fang Huang1,2,3, Chung-Ta Chang4,5,6, Chih-Hsin Muo7, Kuan-Ming Chiu8,9,10, Chun-Hao Tsai11,12, Shih-Ping Liu13,14,15. 1. Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan. 2. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan. 3. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. 4. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan. chungta2001@gmail.com. 5. Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, 22056, Taiwan. chungta2001@gmail.com. 6. Graduate Institute of Medicine, Yuan Ze University, Taoyuan, 32003, Taiwan. chungta2001@gmail.com. 7. Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan. 8. Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City, 22056, Taiwan. 9. Department of Nursing, Oriental Institute of Technology, New Taipei City, 22056, Taiwan. 10. Department of Electrical Engineering, Yuan Ze University, Taoyuan, 32003, Taiwan. 11. Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan. 12. Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan. 13. Program for Aging, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 40402, Taiwan. spliu@mail.cmuh.org.tw. 14. Center for Translational Medicine, China Medical University and Hospital, Taichung, 40402, Taiwan. spliu@mail.cmuh.org.tw. 15. Department of Social Work, Asia University, Taichung, 41354, Taiwan. spliu@mail.cmuh.org.tw.
Abstract
OBJECTIVES: This study aimed to determine the relation between temporomandibular disorder (TMD) and ankylosing spondylitis (AS) bidirectionally and ascertain the important comorbidities for AS occurrence in TMD patients. MATERIALS AND METHODS: We conducted this population-based cohort study through Longitudinal Health Insurance Database, Taiwan. Study 1 investigated the risk of TMD in AS patients. Study 2 assessed the risk of AS in TMD patients. RESULTS: In total, 3204 AS patients and 12,816 age-matched and gender-matched comparisons were enrolled in study 1. The TMD incidence in the AS cohort was 2.88-fold higher when compared with the comparisons (1.54 vs. 0.53 per 10,000 person-years). After adjusting for age, gender, and comorbidity, the AS cohort had a 2.66-fold (95% CI = 1.79-3.97) increased risk of TMD occurrence (P < 0.0001). The second study recruited 4998 TMD patients and 19,991 age-matched and gender-matched comparisons. Both TMD and comparison cohorts showed similar AS risk (HR = 1.49, 95% CI = 0.91-2.43, P = 0.1108) in the adjusted model. Study 2 identified a 3.66-fold increased risk of AS occurrence in TMD patients with comorbidity, including parapsoriasis, rheumatoid arthritis, osteoporosis, Cushing's syndrome, and climacteric arthritis (P < 0.012). CONCLUSIONS: AS appears to significantly impact the occurrence of TMD. TMD might play a synergic role in AS development. CLINICAL RELEVANCE: Clinicians have to be vigilant about the increased risk of TMD in AS patients and take care of AS disease activity and prognosis. The symptoms and signs of TMD could be a predictor of AS in patients with the aforementioned comorbidities.
OBJECTIVES: This study aimed to determine the relation between temporomandibular disorder (TMD) and ankylosing spondylitis (AS) bidirectionally and ascertain the important comorbidities for AS occurrence in TMDpatients. MATERIALS AND METHODS: We conducted this population-based cohort study through Longitudinal Health Insurance Database, Taiwan. Study 1 investigated the risk of TMD in AS patients. Study 2 assessed the risk of AS in TMDpatients. RESULTS: In total, 3204 AS patients and 12,816 age-matched and gender-matched comparisons were enrolled in study 1. The TMD incidence in the AS cohort was 2.88-fold higher when compared with the comparisons (1.54 vs. 0.53 per 10,000 person-years). After adjusting for age, gender, and comorbidity, the AS cohort had a 2.66-fold (95% CI = 1.79-3.97) increased risk of TMD occurrence (P < 0.0001). The second study recruited 4998 TMDpatients and 19,991 age-matched and gender-matched comparisons. Both TMD and comparison cohorts showed similar AS risk (HR = 1.49, 95% CI = 0.91-2.43, P = 0.1108) in the adjusted model. Study 2 identified a 3.66-fold increased risk of AS occurrence in TMDpatients with comorbidity, including parapsoriasis, rheumatoid arthritis, osteoporosis, Cushing's syndrome, and climacteric arthritis (P < 0.012). CONCLUSIONS: AS appears to significantly impact the occurrence of TMD. TMD might play a synergic role in AS development. CLINICAL RELEVANCE: Clinicians have to be vigilant about the increased risk of TMD in AS patients and take care of AS disease activity and prognosis. The symptoms and signs of TMD could be a predictor of AS in patients with the aforementioned comorbidities.
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