This investigation studied current clinical signs of temporomandibular joint (TMJ) occurring in association with rheumatoid arthritis (RA) by questionnaire, and evaluated the association between TMJ pain and clinical/laboratory parameters, such as the duration of disease, RA-stage, treatment, C-reactive protein (CRP), and rheumatoid factor (RF). This study was comprised of 50 individuals with RA (12 males and 38 females; mean age: 58.3 years; 7 Stage I, 24 Stage II, 7 Stage III and 12 Stage IV; mean duration of the disease: 105 months), being treated in the Division of Nephrology and Rheumatology, Kawasaki Medical School Hospital. All were on medication with disease-modifying antirheumatic drugs. Ten (20%) of the 50 patients had some TMJ symptoms at the time of the investigation. TMJ pain (16%) was the most common, followed by trismus (10%), TMJ stiffness (8%) and TMJ swelling (4%). The degree of TMJ pain on the visual analog scale (from 0 to 100 mm) in the 50 patients ranged from 0 to 52 mm. The degree of TMJ disturbance on the visual analong scale (from 0 to 100 mm) ranged from 0 to 55 mm in the 50 patients. For 8 patients with TMJ pain (WP group), the mean and median levels of serum CRP were 1.01mg/dl and 0.68mg/dl, respectively (range: 0.13 to 3.37mg/dl), while the mean and median levels of serum RF were 41.8IU/ml and 28.0IU/ml (range: 0 to 132IU/ml). In the 42 patients without TMJ pain (WOP group), the mean and median levels of serum CRP were 1.53mg/dl and 1.24mg/dl, respectively (range: 0 to 5.52mg/dl), while the mean and median levels of serum RF were 159.0IU/ml and 60.0IU/ml (range: 0 to 1, 460IU/ml). The Mann-Whitney U-test revealed that there was no statistically significant difference between the WP and WOP groups in the levels of either CRP or RF. Logistic regression analysis revealed no correlation between the TMJ pain and clinical/laboratory parameters.

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Purpose: The purpose of this study was to measure the activity of reactive oxygen species in the synovial lavage fluid of patients diagnosed with articular temporomandibular joint disc derangement without reduction and to investigate the correlation between the level of reactive oxygen species and inflammation.
Materials and Methods: Fifty-five subjects diagnosed with articular temporomandibular joint disc derangement without reduction and 15 healthy volunteers were included in this study. Synovial lavage fluids from a superior joint space were collected and the level of reactive oxygen species was determined. Patients were divided into three subgroups based on the arthroscopic findings of the synovitis.
Results: Reactive oxygen species could be detected by fluorescence probe in both the patient and control groups. The detection rate of the reactive oxygen species in the patient group was significantly higher than in the control group. The levels of reactive oxygen species in the patient and control groups were 2.2nmol/mg protein and 4.2nmol/mg protein, respectively. The level of reactive oxygen species in synovial lavage fluid was significantly higher in the patient group (p<0.05). The synovitis score assessed by arthroscopy and the level of reactive oxygen species were also significantly associated (p<0.05). However, the detection rate of reactive oxygen species between the patient and control groups, among the three subgroups divided by synovitis score was not significantly different.
Conclusion: These results suggested that reactive oxygen species might play an important role in the pathogenesis of temporomandibular joint disorder.

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