CLINICAL AND RADIOGRAPHIC (CBCT) FEATURES OF TMJ IN RELATION TO DISEASE ACTIVITY AND DURATION IN RHEUMATOID ARTHRITIS, ANKYLOSING SPONDYLITIS PATIENT

Background: Rheumatoid arthritis (RA) is an immune-mediated inflammatory condition that involves the symmetrical joints, and 50% of them exhibit TMJ involvement. Ankylosing spondylitis is a chronic systemic inflammatory disorder primarily affecting the axial skeleton. Disease activity of RA was measured by the combined index of dass (28) and for AS by the index of ASDAS. The Helkimo index is a validated metric for evaluating temporomandibular disorders (TMD) within a defined population. The study aimed to assess TMJ involvement in RA and AS affection about the clinical, and radiological changes of TMJ by CBCT, to Determine osteo-arthritic changes of TMJ about disease activity index. Materials and Methods: This study used a cross-sectional design involving 31 patients (21 with RA, 10 with AS) we examined the TMJ using helkimo index then we figured out the disease severity by using dass (28), ASDAS and radiographic changes in TMJ, using CBCT. Results: About the helkimo index of TMPD, the majority (70%) of AS patients had fatigue in the joint, compared with 23.8% of the RA patients. No significant differences were detected between the two groups of patients about joint sound, morning rigidity difficulty in the opening, locked mandible in the opening, and muscle pain, about all the CBCT findings, and anamnestic symptoms and these factors: age, disease duration, and disease activity scale (DAS28). The same can be applied to the AS group, where no significant association was detected with age, disease duration, and ASDAS. Conclusion: About the helkimo index, anamnestic results mild cases were less than severe in RA patients but in AS mild cases were more than the sever. Clinical dysfunction severe cases were more in RA just like the AS Patients. CBCT shows no significant differences between two groups of patients.