Mandibular movements in older people with rheumatoid arthritis

Growth curves for mandibular range of motion and maximum voluntary bite force in healthy children

Mandibular range of motion and bite force are indispensable variables for the evaluation of mandibular function. There are a variety of medical and dental conditions that can negatively affect mandibular function. Values for mandibular range of motion (i.e., active and passive maximum interincisal mouth opening, protrusion, and laterotrusion) and anterior maximum voluntary bite force (AMVBF) in healthy children and adolescents can help in recognizing temporomandibular dysfunction. In this longitudinal study, 169 healthy children aged 6-18 years were included. They were examined at four time points over 1 year. Mixed model analysis was performed to produce growth curves of mandibular range of motion and AMVBF. Average active maximum interincisal mouth opening was significantly higher in boys with 50.0 mm compared to 47.8 mm in girls. Boys also had a significantly higher AMVBF than girls with an average of 169.0 N versus 140.0 N, respectively. Growth curves of active and passive maximum interincisal mouth opening showed an increase with age, albeit levelling off through puberty. The growth curves of AMVBF in girls reach a plateau phase at ages 12-14 years, after which the curve descends; in boys, the AMVBF tended to increase up to 18 years of age, although a slow-down after 14 years of age was noted.

Removable prostheses improve OHRQL and satisfaction of elderly people with rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P<0.05) for all OHIP-14 domains before insertion of new dentures. Group 2 showed worst means (P<0.05) compared to controls for functional limitation and physical pain domains of the OHIP-14, but not in the general score. Patients showed better outcomes of satisfaction with prostheses use only after the new rehabilitation. Conclusion: The use of new and well-fitted dentures improves all domains of OHRQoL in patients with RA and TMD and all groups were satisfied with prostheses use after the new rehabilitation with conventional dentures.

Intricate Estimation and Evaluation of Mandibular Movements in Geriatric Patients Suffering from Rheumatoid Arthritis

BACKGROUND

Rheumatoid arthritis (RA) is an autoimmune disorder that usually affects joints and making them warm, painful, and swollen. The chief purpose of this study was to evaluate movements of mandible in geriatric patients suffering from RA with or without temporomandibular joint dysfunction.

MATERIALS AND METHODS

A total of 45 people were included in this study with age of 60 years and above. Partially or completely edentulous patients were divided into experimental and control group. Experimental group consists of 20 people suffering from arthritis and control group consists of 25 people without arthritis. Movements were recorded with or without prosthesis while mastication in both experimental and control group.

RESULTS

Statistical evaluation of two studied groups showed decrease opening angle (p < 0.05) during mastication; however, insertion of new prosthesis showd a significant increase in values in both groups, with an increase in opening and closing angles.

CONCLUSION

Positive correlation was found between arthritis and movements of the mandible in older people suffering from RA.

CLINICAL SIGNIFICANCE

Patients suffering from RA are having restricted mandibular movements thus imposing an overall negative impact however; presence of prosthesis has been shown to enforce a positive effect on mandibular movement.