Evaluation of Changes in the Temporomandibular Joint in Patients with Rheumatoid Arthritis via Panoramic Radiographs

Abstract

Aim: The aim of this study was to evaluate degenerative bone changes in the temporomandibular joint in patients with rheumatoid arthritis (RA) using panoramic radiographs and to compare the findings control group.

Material and Methods: A total of 100 subjects, 50 RA patients and 50 controls, were included in this study. Degenerative changes on the panoramic radiographs of the patients were evaluated according to the presence of erosion, flattening, osteophytes, subchondral cysts and sclerosis. The occurrence of one or more than one degenerative changes and joint involvement (no involvement, unilateral/bilateral involvement) between the groups were recorded. Statistical analysis of the data was performed using Pearson’s Chi-square test and Fisher's exact test. The Cohen's kappa test was used to measure intraobserver agreement. p<0.05 was considered statistically significant.

Results: Flattening (p<0.001), erosion (p=0.005), sclerosis (p=0.037) and subchondral cyst (p=0.035) were found to be statistically significantly higher in the study group than in the control group. It was determined that the occurrence of both one and more than one degenerative changes was higher in the study group than in the control group. A statistically significant difference was found in the distribution of joint involvement between the groups (p <0.001). The intraobserver kappa value was 0.951.

Conclusion: Degenerative changes in the temporomandibular joint were observed more frequently in patients with RA than the controls. For this reason, temporomandibular joint examination should not be ignored during the clinical examination of RA patients, and evaluation can be performed with appropriate imaging technique in terms of possible degenerative changes.

Keywords

• Panoramic radiography
• rheumatoid arthritis
• temporomandibular joint

Romatoid Artritli Hastalarda Temporomandibular Eklemdeki Değişikliklerin Panoramik Radyograflar Aracılığıyla Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı romatoid artritli (RA) hastalarda temporomandibular eklemdeki dejeneratif kemik değişikliklerini panoramik radyograflar kullanarak değerlendirmek ve bulguları kontrol grubuyla karşılaştırmaktır.

Gereç ve Yöntemler: Bu çalışmaya 50 RA hastası ve 50 kontrol grubu olmak üzere 100 kişi dahil edildi. Hastaların panoramik radyograflarındaki dejeneratif değişiklikler erozyon, düzleşme, osteofit, subkondral kist ve skleroz görülme durumlarına göre değerlendirildi. Gruplar arasında tek veya birden fazla dejeneratif değişiklik görülme durumu ile eklem tutulumu (tutulum yok, unilateral/bilateral tutulum) kayıt altına alındı. Verilerin istatistiksel analizi Pearson Ki-kare testi ve Fisher’s exact testi kullanılarak yapıldı. Gözlemci içi uyumu ölçmek için Cohen'in kappa testi kullanıldı. İstatistiksel olarak p<0,05 anlamlı kabul edildi.

Bulgular: Düzleşme (p<0,001), erozyon (p=0,005), skleroz (p=0,037) ve subkondral kist (p=0,035) çalışma grubunda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha yüksek bulundu. Çalışma grubunda hem tek hem de birden fazla dejeneratif değişikliğin görülme oranının kontrol grubuna göre daha yüksek olduğu tespit edildi. Gruplar arasındaki eklem tutulumu dağılımında istatistiksel olarak anlamlı farklılık bulundu (p <0,001). Gözlemci içi kappa değeri 0,951'di.

Sonuç: RA’lı hastalarda temporomandibular eklemdeki dejeneratif değişiklikler kontrol grubuna göre daha sık gözlendi. Bu sebeple RA hastalarının klinik muayenesi yapılırken temporomandibular eklem muayenesi göz ardı edilmemeli, olası dejeneratif değişiklikler açısından uygun görüntüleme tekniği ile değerlendirme yapılabilir.

Keywords

• Panoramik radyografi
• romatoid artrit
• temporomandibular eklem

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