The effect of methotrexate on the temporomandibular joint in polyarticular juvenile rheumatoid arthritis patients.

Temporomandibular joint (TMJ) arthropathy is common in juvenile rehumatoid arthritis (JRA) patients and can cause functional and esthetic problems. The purpose of this pilot study was to begin to evaluate whether methotrexate (MTX) therapy can reduce TMJ arthropathy in patients with polyarticular JRA.There were 27 patients with polyarticular JRA studied. Of these, 18 were receiving MTX and non-steroidal anti-inflammatory drugs and 9 were receiving just non-steroidal anti-inflammatory drugs. A routine physical examination, including a detailed joint evaluation, was performed by their rheumatologist. A craniofacial examination was performed by the orthodontist and included a radiographic TMJ evaluation (panoral and corrected axial tomograms).Radiographic evidence of condylar degeneration was apparent in 83% of all polyarticular JRA patients. The patients receiving MTX showed less severe TMJ involvement than those not receiving MTX.