Int J Med Sci 2018; 15(5):475-483. doi:10.7150/ijms.23044

Research Paper

Orofacial Manifestations and Temporomandibular Disorders of Sjögren Syndrome: An Observational Study

Vito Crincoli1✉, Mariasevera Di Comite2, Mariateresa Guerrieri1, Rossana Patricia Rotolo 1, Luisa Limongelli1, Angela Tempesta1, Florenzo Iannone3, Angela Rinaldi3, Giovanni Lapadula3, Gianfranco Favia1

1. Interdisciplinary Department of Medicine, University of Bari, Italy.
2. Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Italy.
3. Department of Emergency and Organ Transplantation, University of Bari, Italy.

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Crincoli V, Di Comite M, Guerrieri M, Rotolo RP, Limongelli L, Tempesta A, Iannone F, Rinaldi A, Lapadula G, Favia G. Orofacial Manifestations and Temporomandibular Disorders of Sjögren Syndrome: An Observational Study. Int J Med Sci 2018; 15(5):475-483. doi:10.7150/ijms.23044. Available from

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AIMS: Sjӧgren Syndrome is a disorder involving oral tissues, with xerostomia, dysgeusia, dysphagia, tooth decay, gingivitis, angular cheilitis and glossitis. Temporomandibular disorders are a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in Sjӧgren Syndrome (SS) patients compared with healthy people.

METHODS: The study group included 72 SS patients (2 men, 70 women) diagnosed according to the American-European Consensus Group (AECG) Criteria. A randomly selected group of 72 patients, matched by sex and age, served as control group. The examination for TMD signs and symptoms was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination.

RESULTS: SS patients complained more frequently (95.8%) of oral symptoms (xerostomia, dysgeusia, dysphagia) than controls (22.2%) (χ2= 80.66 p< 0.001). TMD symptoms (muscle pain on chewing, difficulty in mouth opening, arthralgia, headaches, tinnitus) were complained by 91.7% of SS patients and by 84.7% of controls (χ2= 1,667 p= 0,196). At the clinical examination, 91,7% of SS had at least one oral sign respect to 75 % of controls. The salivary flow measurements showed high statistical significance between the two groups (Unpaired test, p< 0,0001). Myofascial pain (caused by muscular contracture) was significantly higher in the study group than in the control one (p≤ 0,05). Furthermore 18,05% of SS patients showed deflection versus 5,5% of controls (χ2=5,402 p=0,020).

CONCLUSIONS: Sjӧgren's Syndrome seems to play a role in temporomandibular joint disorders.

Keywords: Sjӧgren's Syndrome, oral manifestation, temporomandibular disorders, RDC/TMD.