Skeletal Fluorosis-Induced Morphological Changes of the Temporomandi bular Joint and Associated Functional Limitations among Adults in Ethiopia

Author(s): Heron Gezahegn

Skeletal fluorosis is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride. The clinical manifestations of the disease range from mild joint pain to severe bone deformities. Joint pain, stiffness of joints, and abnormal growth of the upper and lower extremities are some of the symptoms of the disease. In its severe form (crippling fluorosis), the disease can cause a rigid, stiffened spine that renders the patient virtually immobile. However, the adverse effects of skeletal fluorosis are not limited to the spine and the upper and lower extremities of the body. The joints and bones in the anatomical region of the oro-skull are also similarly affected by the condition. Despite that, there are insufficient data on the biological effects of skeletal fluorosis in this essential anatomical region. A one point, investigative, cross-sectional study was conducted to determine possible skeletal fluorosis-related morphologic changes in the T.M.J. and associated functional limitations among individuals diagnosed with skeletal fluorosis. The study included 9 participants with skeletal fluorosis and was conducted between February 4, 2023, and March 20, 2023. A two-dimensional orthopantomogram was used to rule out possible skeletal fluorosis-related morphological changes in the temporomandibular joint. The TheraBite TMJ ROM scale was used to evaluate the R.O.M. of the T.M.J. by measuring the distance between the maxillary and mandibular cutting edges (interincisal open distance). The temporomandibular joint was auditioned to with a stethoscope for possible noises. Radiographs of the 8 study participants showed morphologic changes such as ossification of various joint structures, osteophytosis, osteophytes, and hyperostosis. In addition, 6 study participants had varying degrees of temporomandibular joint ankylosis. Of these, 4 participants showed low-intensity crepitus sounds on stethoscope auscultation. The results of this study suggest that skeletal fluorosis should be considered as the first differential diagnosis in patients complaing of pain, abnormal sounds, and stiffness related to the temporomandibular joint.

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