[Joint and functional changes in the masticatory system in chronic rheumatoid arthritis in adults. Preliminary study]

A clinical and radiological study has been carried out to highlight signs and symptoms of mandibular dysfunction in a sample of 66 adult patients suffering from chronic rheumatoid arthritis. Data were quantified on the basis of Helkimo indices. Prevalence proved significantly high, particularly as regards joint crepitus, reduced mandibular mobility, pain in the masticatory muscles and macroglossia. It did not seem to be linked to age. Rather it presented a definite predominance of the female sex, confirmed by comparison with a sample of nonrheumatic controls. Contemporaneous X-ray examination showed a bilateral location, in many cases remodelling and reabsorption of the condyle, an increase in the articular space and erosion of the fossa, at times reduction in the space and sclerosis, dependent on a superimposed degenerative arthrosis (usually more painful). Generally speaking, however, there was a coincidence between severity of clinical dysfunction and seriousness of the morphological lesions whereas subjective symptoms were relatively independent. The need for polyspecialistic cooperation and a multidisciplinary therapeutic approach is reiterated.