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.