Temporomandibular disorders in immune-mediated rheumatic diseases of the adult: A systematic review
Authors' conclusion
TMDs in IMRDs display a significant relevance in the rheumatological clinical practice even if often misdiagnosed. This burden is epidemiologically important in terms of PROs and clinical findings which correlate with disease activity in RA, SpA, SSc and SLE.
Study context
- Population
- Adults with immune-mediated rheumatic diseases (inflammatory polyarthritides and/or autoimmune connective tissue diseases (CTDs)); studies of temporomandibular joint (TMJ) outcomes vs healthy controls, other rheumatic diseases or after follow-up and treatment56 papers
- Comparison
- Rheumatoid arthritis (RA) vs spondylarthritides (SpA) vs systemic sclerosis (SSc) vs systemic lupus erythematosus (SLE) vs Primary Sjogren's syndrome vs IIM
- Outcome
- Prevalence of TMDs in immune-mediated rheumatic diseases (IMRDs), TMJ outcomes used and risk factors for TMD development
Methodological detailsqualitative synthesis, quality scored with Newcastle-Ottawa scale, Searched PubMed Central, Embase and Cochrane Library; 3259 abstracts screened
- Qualitative synthesis
- Quality scored with Newcastle-Ottawa scale
- Searched PubMed Central, Embase and Cochrane Library; 3259 abstracts screened
Pooled result
As reported in the abstract
Prevalence of TMD signs and symptoms
RA
8% to 70%
SpA
12%-80%
SSc
20-93%
SLE
18-85%
Primary Sjogren's syndrome
24-54%
IIM
4-26%
Further pooled results
Risk factors for temporomandibular disorders (TMDs)
- RA: female sex, younger age, anti-citrulline peptide autoantibodies (ACPA) positivity, higher disease activity, cervical spine involvement, cardiovascular and neuropsychiatric comorbidities
- SpA: higher prevalence with radiographic spine involvement, skin psoriasis and HLADRB1×01 positivity
- SSc and SLE: more frequent with higher disease activity and duration; correlating with skin fibrosis extent in SSc and renal involvement in SLE
Original publication
Temporomandibular disorders in immune-mediated rheumatic diseases of the adult: A systematic review. Semin Arthritis Rheum. Published 5 May 2023. doi:10.
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