Influence of removable prostheses on mastication in elderly subjects with rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a prevalent disease in the elderly population, and it may affect the temporomandibular joint (TMJ) and the stomatognathic system. This study evaluated masticatory function in elderly patients with RA before and after oral rehabilitation with removable prostheses. Forty-five elders with partial or total edentulism who were using unsatisfactory removable prostheses were selected and assigned to 3 groups: RA with TMJ involvement, RA without TMJ involvement and healthy controls. Masticatory function was assessed in terms of masticatory performance (MP) and maximum bite force (MBF). The former was determined by the sieving method, and the latter was measured by pressure sensors placed in the bilateral molar regions. The variables were first evaluated in elderly subjects wearing unsatisfactory prostheses and re-assessed after participants had received new removable prostheses. Comparisons between groups and among time points were performed with analysis of variance for repeated measures and the Tukey-Kramer test (P < .05). Comparison among groups showed decreased MP in elders with RA before new prosthesis insertion (P < .05). Irrespective of TMJ involvement, MP improved after treatment in subjects with RA. Rheumatoid arthritis groups also showed decreased MBF (P < .05), which improved after new prosthesis insertion. Rheumatoid arthritis might impair masticatory function, and well-fitted removable prosthesis insertion might be very beneficial in elders with RA.

Keywords: elderly; masticatory performance; rheumatoid arthritis; temporomandibular disorder.