DETERMINANTS OF STRUCTURAL DAMAGE IN TEMPOROMANDIBULAR JOINT INVOLVEMENT OF RHEUMATOID ARTHRITIS: AN MRI-BASED CROSS-SECTIONAL STUDY

Manolya İlhanlı, Peruze Çelenk

Abstract


Rheumatoid arthritis (RA) commonly affects the temporomandibular joint (TMJ); however, the determinants of structural damage remain unclear. This study aimed to investigate the factors associated with the degenerative burden of the TMJ using magnetic resonance imaging (MRI) in patients with RA. This cross-sectional study included 44 patients diagnosed with RA according to the 2010 ACR/EULAR criteria. Clinical variables, including age, disease duration, disease activity score (DAS28), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) were recorded. TMJ structural abnormalities were evaluated using MRI. Degenerative burden was defined as the total number of distinct degenerative findings (cortical irregularity/resorption, flattening, osteophyte formation, joint space narrowing, and effusion), ranging from 0 to 5. Multivariate linear regression analysis was performed to identify factors associated with degenerative burden. The mean age of the patients was 47.73 ± 13.65 years, and the median disease duration was 84 months. The regression model explained 18.8% of the variance in degenerative burden (R² = 0.188), but was not statistically significant (p = 0.145). Among the independent variables, disease duration showed a trend toward association with degenerative burden (β = 0.278, p = 0.092). No significant associations were found for age (p = 0.188), RF positivity (p = 0.163), anti-CCP positivity (p = 0.592), or DAS28 (p = 0.948). Degenerative changes in the TMJ of patients with RA appear to be more closely related to disease chronicity rather than current disease activity. Although no independent predictors reached statistical significance, disease duration demonstrated a trend toward increased structural damage. These findings highlight the importance of long-term monitoring of TMJ involvement in RA patients.

Keywords


rheumatoid arthritis, temporomandibular joint, MRI, degeneration, disease duration

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DOI: http://dx.doi.org/10.46827/ejphs.v8i4.244

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