Temporomandibular joint involvement and dental occlusion in a group of adults with rheumatoid arthritis.

The temporomandibular joint (TMJ) and dental occlusion were investigated clinically and radiographically in 59 patients aged 23-83 (mean, 58) years with general joint disease. Forty-nine had rheumatoid arthritis (RA), mostly of long duration. The patients were divided into four groups by type of dentition. Radiographic TMJ abnormality was found in about 4 of 5 patients with RA, in both the dentate and the edentulous group. The abnormality was mainly destructive with productive signs, but in the edentulous group erosive and asymmetrical changes occurred more often. Almost complete restriction of the condylar translation and severely restricted mouth opening (less than or equal to 30 mm) rarely occurred, although the translatory motion was restricted in several patients. Many of these had a satisfactory mouth opening (greater than 40 mm). Occlusal changes-various degrees of anterior bite opening-were reported by about one fourth of both the dentate patients and the complete denture wearers. One patient had occlusal contact on the second molars only. Anterior bite opening occurred only in patients with radiographic TMJ abnormality, including 5 of the 6 patients with complete mandibular head destruction.