The Risk of Developing Immune-Mediated Rheumatic Disease Among Adult Patients with Temporomandibular Disorders, a Retrospective Single-Center Cohort Study.

OBJECTIVE

To evaluate the risk of immune-mediated rheumatic disease (IMRD) development among adult patients with temporomandibular disorders (TMDs) and to assess the risk factors for developing IMRD among patients with TMDs.

METHODS

A retrospective single-center cohort study that included patients between January 1, 2018 and June 30, 2024. Patients ≥ 18 years old with newly diagnosed TMDs according to the TMD diagnostic criteria, who had ≥ 3 follow-up visits at the center for maxillofacial surgery and dental medicine clinics, Galilee medical center, were included.

RESULTS

A total of 1,129 patients presented with TMDs, 130 patients met the inclusion criteria, of whom 114 (88%) were females. The most common temporomandibular joint (TMJ) symptoms were pain and click sounds in 128 (98.5%) and 24 (18.5%) of patients, respectively. Out of 130 patients with TMDs, 3 patients (2.3%) were diagnosed with IMRD (2 with rheumatoid arthritis (RA) (1.5%), and 1 with familial Mediterranean fever (0.8%)). The median follow-up was 39.9 months (IQR 29.1-51.6), and all patients contributed a total of 431.4 person-years at risk. The incidence rate for IMRD in patients with TMDs in our study was 695.4 per 100,000-person year, and for RA in particular was 463.6 per 100,000-person year None of the evaluated risk factors, including gender, TMJ pain, or other joints pain showed a significant association with the subsequent development of IMRD.

CONCLUSION

In this small retrospective cohort, patients with TMDs have higher incidence of IMRD compared to estimated incidence in the general population, especially RA.