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Ankylosing SpondylitisNCT05839925

Prevalence of Temporomandibular Joint Dysfunction in Patients With Ankylosing Spondylitis

An observational study of Ankylosing Spondylitis, run by Istanbul Physical Medicine Rehabilitation Training and Research Hospital at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study included 113 patients diagnosed with ankylosing spondylitis and 110 healthy volunteers. Participants in both groups were evaluated using the 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)' diagnostic criteria. Read more about this study

Who is it for?
Ages 18 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Ankylosing Spondylitis
What is being tested?
Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and II
How many people
223 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Apr 2022to 1 Apr 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: 113 patients with ankylosing spondylitis were diagnosed and 110 healthy volunteers.

Who may be able to join

  • Patients diagnosed with Ankylosing Spondylitis according to the Modified New York Criteria between the ages of 18-75.
  • Healthy volunteers between the ages of 18 and 75.

Who cannot join

  • Changes in the treatment of ankylosing spondylitis within the last 6 months
  • Patients with pathology related to the temporomandibular joint and associated structures prior to the diagnosis of ankylosing spondylitis
  • Use of medication that affects bone metabolism
  • Presence of neurological or cognitive deficits
  • History of trauma, malignancy, infection, and surgery in the head and neck area
  • Presence of dental or periodontal pain
  • History of orthodontic treatment.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Istanbul Physical Medicine Rehabilitation Training and Research Hospital

    Istanbul

Other trials in Turkey (Türkiye)

About this study

Official title: Prevalence of Temporomandibular Joint Dysfunction in Patients With Ankylosing Spondylitis and Comparison of the Findings With Healthy Controls

This study included 113 patients diagnosed with ankylosing spondylitis and 110 healthy volunteers. Participants in both groups were evaluated using the 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)' diagnostic criteria. In addition, the relationship between temporomandibular joint dysfunction and disease activity was investigated in patients with ankylosing spondylitis.

Read the detailed description

Ankylosing spondylitis (AS) is a chronic, inflammatory disease with an unknown etiology that primarily affects the axial spine, especially the sacroiliac joints, and can also involve peripheral joints and extra-articular clinical manifestations. Complaints related to temporomandibular joint pathologies are commonly observed in the general population but more frequent in the group of patients diagnosed with ankylosing spondylitis compared to the average population. Although the mechanism of temporomandibular joint involvement in ankylosing spondylitis is not fully understood, destruction of the joint capsule or disk, synovitis in the joint, and craniovertebral postural changes have been suggested as possible mechanisms. In addition, pain due to temporomandibular joint dysfunction can significantly affect daily life activities, quality of life, social participation, and the emotional status of the individual. Determining the level of relationship between quality of life and psychological status will support the development of new interventions and treatment approaches to improve patient's quality of life further.

The age, gender, body mass index, marital status, duration of ankylosing spondylitis (AS) diagnosis, symptom onset, treatment for AS, occupation, smoking status, and Human Leukocyte Antigen (HLA)-B27 positivity status were recorded for the patient. The 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD),' published in 2014 and translated into Turkish in 2016, was used to assess the presence of temporomandibular joint dysfunction in the patients. This evaluation system consists of two parts: the clinical evaluation and examination findings of the current pathology on Axis I, and the psychosocial status of the disease on Axis II. The questions in the Symptom Questionnaire on the first axis were directed to the patient, and then the results were recorded by performing the examinations indicated on the examination form. The diagnosis was determined according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) decision tree, and marked on the examination form. Two groups were created based on the decision tree: pain and joint disorders. Pain disorders were further subdivided into muscle pain, joint pain, and TMD-related headaches; muscle pain was further subdivided into local muscle pain, muscle-fascial pain, and referred muscle-fascial pain subgroups. Joint disorders were classified as disc displacement with reduction, disc displacement with reduction-intermittent locking, disc displacement without reduction-limited mouth opening, disc displacement without reduction-limited mouth opening, degenerative joint disease, and dislocation.

On Axis II, the patients were asked to mark the areas where they felt pain on the pain drawing form. The marked area was divided into categories according to its size. The level of experienced pain was evaluated with the Graded Chronic Pain Scale (GCPS), jaw function limitations were assessed with the Jaw Functional Limitation Scale-20 (JFLS-20), depression was evaluated with the Patient Health Questionnaire-9 (PHQ-9), anxiety was assessed with the General Anxiety Disorder 7 (GAD-7), physical symptoms were evaluated with the Patient Health Questionnaire-15 (PHQ-15), and parafunctional activities were evaluated with the Oral Behavior Checklist (OBC). Additionally, the relationship between the identified diagnosis and psychosocial factors, disease activity, and other disease-specific factors was investigated.

Being tested
Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and II
Keywords
Ankylosing Spondylitis, Temporomandibular Joint Disorders, Temporomandibular Disorders, TMJ, Spondyloarthropathy
Medical subject headings
Spondylitis, Ankylosing, Temporomandibular Joint Disorders, Spondylarthropathies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and IIDiagnostic test

    The presence of temporomandibular joint dysfunction was evaluated using the diagnostic criteria for temporomandibular disorders (DC/TMD).

Study groups in NCT05839925
Study groupRoleWhat they receive
Ankylosing spondylitis groupThe patients were selected on a randomized form among the patients with a diagnosis of AS according to the modified New York criteria who referred to Istanbul Physical Medicine Rehabilitation Training and Research Hospital.
Receives: Diagnostic Test: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and II
Healthy volunteersHealthy volunteers between the ages of 18-75 were selected randomly.
Receives: Diagnostic Test: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and II

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I Symptom questionnaire

    The presence of temporomandibular joint dysfunction will be evaluated using the The questionnaire that investigates temporomandibular region pain and characteristics, joint sounds, and headache was used.

    Measured: A single point in time (1 day)

  2. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I Clinical Examination Form questionnaire

    Clinical Examination form assesses the site of pain, incisal relationships, mouth opening position, mouth opening and closing movements, lateral and protrusive movements, jaw noise, joint locking, and evaluation of muscle and joint pain by palpation.

    Measured: A single point in time (1 day)

Secondary outcomes (10)
  1. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess the disease activity.

    Measured: A single point in time (1 day)

  2. Bath Ankylosing Spondylitis Functional Index (BASFI)

    Bath Ankylosing Spondylitis Functional Index (BASFI) is a tool used to assess the functional ability of patients with ankylosing spondylitis. It includes questions about the patient's ability to perform daily activities such as dressing, grooming, standing, and bending.

    Measured: A single point in time (1 day)

  3. The Bath Ankylosing Spondylitis Metrology Index (BASMI)

    The Bath Ankylosing Spondylitis Metrology Index (BASMI) was used to assess spinal mobility. The Bath Ankylosing Spondylitis Metrology Index (BASMI) includes measurements of tragus-to-wall distance, intermalleolar distance, modified Schober's test, lateral flexion, and cervical rotation.

    Measured: A single point in time (1 day)

  4. DC/TMD Axis II-Pain Drawing questionnaire

    Pain Drawing which assesses pain location and spread.

    Measured: A single point in time (1 day)

  5. DC/TMD Axis II-Patient Health Questionnaire-9 (PHQ-9)

    Patient Health Questionnaire-9 (PHQ-9), which assesses depressed mood state.

    Measured: A single point in time (1 day)

  6. DC/TMD Axis II- Oral Behaviors Checklist (OBC)

    Oral Behaviors Checklist (OBC), which assesses parafunctional behaviors

    Measured: A single point in time (1 day)

  7. DC/TMD Axis II-Jaw Functional Limitation Scale-20 (JFLS-20)

    Jaw Functional Limitation Scale-20 (JFLS-20) , which assesses limitation of mastication, mobility and verbal end emotional expressions.

    Measured: A single point in time (1 day)

  8. DC/TMD Axis II-Patient Health Questionnaire-15 (PHQ-15)

    Patient Health Questionnaire-15, which assesses non-specific physical symptoms

    Measured: A single point in time (1 day)

  9. DC/TMD Axis II-Graded Chronic Pain Scale; GCPS v2.0

    Graded Chronic Pain Scale (GCPS) is a tool used to assess the severity and impact of chronic pain on a person's life. It involves rating the intensity of pain, as well as how much pain interferes with daily activities and quality of life.

    Measured: A single point in time (1 day)

  10. DC/TMD Axis II- General Anxiety Disorder 7 (GAD-7)

    The General Anxiety Disorder 7 (GAD-7) is a brief self-report questionnaire that is used to assess the severity of generalized anxiety disorder

    Measured: A single point in time (1 day)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 May 2023
  2. Study start1 Apr 2022
  3. Primary completion1 Jul 2022
  4. Study completion1 Apr 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
223 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05839925
Sponsor's protocol ID
IstanbulPRMTRH
Status last verified
Feb 2024
First submitted
21 Apr 2023
Last updated
20 Feb 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bilgin E, Bilgin E, Ozdemir O, Kalyoncu U. Temporomandibular disorders in ankylosing spondylitis: a cross-sectional, monocentric study. Rheumatol Int. 2020 Jun;40(6):933-940. doi: 10.1007/s00296-020-04563-y. Epub 2020 Apr 1.

    PubMed 32239320
  • Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007 Apr 21;369(9570):1379-1390. doi: 10.1016/S0140-6736(07)60635-7.

    PubMed 17448825
  • Huang YF, Chang CT, Muo CH, Chiu KM, Tsai CH, Liu SP. Bidirectional relationship between temporomandibular disorder and ankylosing spondylitis: a population-based cohort study. Clin Oral Investig. 2021 Nov;25(11):6377-6384. doi: 10.1007/s00784-021-03938-0. Epub 2021 Apr 14.

    PubMed 33855657
  • Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, Braun J, Chou CT, Collantes-Estevez E, Dougados M, Huang F, Gu J, Khan MA, Kirazli Y, Maksymowych WP, Mielants H, Sorensen IJ, Ozgocmen S, Roussou E, Valle-Onate R, Weber U, Wei J, Sieper J. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009 Jun;68(6):777-83. doi: 10.1136/ard.2009.108233. Epub 2009 Mar 17.

    PubMed 19297344
  • Souza RC, de Sousa ET, Sousa D, Sales M, Dos Santos Oliveira R, Mariano MH, Rushansky E, Amorim Gomes AC, Silva E. Prevalence of Temporomandibular Joint Disorders in Patients with Ankylosing Spondylitis: A Cross-Sectional Study. Clin Cosmet Investig Dent. 2021 Nov 11;13:469-478. doi: 10.2147/CCIDE.S320537. eCollection 2021.

    PubMed 34795532
  • Ahisha BS, Kesiktas FN. Prevalence of temporomandibular joint dysfunction in patients with ankylosing spondylitis and comparison of the findings with healthy controls. Rev Assoc Med Bras (1992). 2024 Sep 30;70(10):e20240807. doi: 10.1590/1806-9282.20240807. eCollection 2024.

    PubMed 39356963

Questions about this trial

What is this clinical trial studying?

An observational study of Ankylosing Spondylitis, run by Istanbul Physical Medicine Rehabilitation Training and Research Hospital at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I Symptom questionnaire (time frame: A single point in time (1 day)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05839925, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2024.

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Clinical Trial NCT05839925 | AzTrials