Laboratorio PABIOM, Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, 31125, Chihuahua, Chihuahua, Mexico.
Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, Mexico.
Rheumatol Int. 2020 Mar;40(3):445-453. doi: 10.1007/s00296-019-04440-3. Epub 2019 Sep 17.
The aim of the study was to describe the oral health and orofacial function of Mexican patients with rheumatoid arthritis (RA) and their association with clinical and radiological aspects of the disease. Patients with RA received a complete odontological exam, which also included a clinical and radiographic assessment of the temporomandibular joint (TMJ). The rheumatologic assessment included detailed profiling of the disease and serological and radiographic parameters. The study included 62 RA patients; the median (min-max) age was 51 (18-72) years old and 8.5 (1-39) years of disease duration. The 63.6% of the patients had DAS28 ≥ 3.2, and a median (min-max) of Sharp/van der Heijde score (SvdHS) of 41 (0-214). 98.3% of the patients presented caries, which were severe in 53.3% of the cases. The 73.8% of the patients were missing teeth due to caries, with a median (min-max) of 4 (0-32) teeth missing per patient. Oral hygiene was classified as bad in 49.1% of patients and only 15.3% of them had a healthy periodontium. The TMJ function was abnormal in 98.4% of the patients and 62.9% of them presented moderate or severe TMJ disorder (TMD). The radiographic damage of the TMJ correlated positively with the SvdHS. No correlations were found between disease activity or structural progression and orofacial variables, including periodontitis. There are severe oral and orofacial health problems in RA patients despite having medical attention for their disease. Multidisciplinary management remains an area of opportunity for both the medical specialists and the health system in our country.
本研究旨在描述墨西哥类风湿关节炎（RA）患者的口腔健康和口腔功能及其与疾病的临床和影像学表现的关系。RA 患者接受了全面的口腔检查，包括对颞下颌关节（TMJ）的临床和影像学评估。风湿评估包括对疾病的详细分析以及血清学和影像学参数。本研究纳入了 62 名 RA 患者；中位（最小-最大）年龄为 51（18-72）岁，疾病持续时间为 8.5（1-39）年。63.6%的患者 DAS28≥3.2，Sharp/van der Heijde 评分（SvdHS）中位数（最小-最大）为 41（0-214）。98.3%的患者存在龋齿，其中 53.3%的患者为重度龋齿。73.8%的患者因龋齿缺失牙齿，中位数（最小-最大）为 4（0-32）颗。49.1%的患者口腔卫生状况较差，仅有 15.3%的患者牙周健康。98.4%的患者 TMJ 功能异常，62.9%的患者存在中度或重度 TMJ 疾病（TMD）。TMJ 的放射学损伤与 SvdHS 呈正相关。疾病活动度或结构进展与口腔变量（包括牙周炎）之间无相关性。尽管患者已经接受了疾病的治疗，但仍存在严重的口腔和口腔颌面部健康问题。多学科管理仍然是我们国家医学专家和卫生系统的一个机会领域。
