Background: Oral health issues are commonly reported in systemic sclerosis (SSc), comprising a broad spectrum of manifestations, e.g., reduced mouth opening, periodontal disease, increased periodontal ligament (PDL) space width, and mandibular resorption. We aimed to assess oral radiographic abnormalities, particularly PDL space widening and erosions, and to identify potential relations with disease measures. Methods: cross-sectional study in 43 SSc and matching controls receiving systematic oral assessments (full mouth dental/periodontal) and imaging (radiographs and cone beam computed tomography (CBCT)). Associations between disease variables and radiologic findings were investigated by univariate and multivariate analysis (SPSS-v.20, p < 0.05). Results: CBCT demonstrated generalized PDL space widening in up to half SSc, with at least one tooth involved, essentially in the posterior region (p < 0.05). Significant correlations between number of teeth with PDL space widening and disease severity, skin score, disease subset, topoisomerase I specificity, age, and disease duration were reported (p < 0.05). Additionally, mandibular erosions were described in one out of four patients, commonly condylar erosions. Conclusions: Tridimensional CBCT approach confirmed widening of PDL and mandibular erosions as common dental findings in scleroderma. Furthermore, widened PDL spaces correlated with several disease characteristics including severity, skin extent, and antibody profile.

BackgroundAlthough the orofacial manifestations are commonly reported among patients with systemic sclerosis (SSc), only few studies have adequately addressed the issue of oral health-related quality of life (QoL) in such pathobiological settings.ObjectivesThe aim was to characterize the oral health status (OHS) of adults with SSc and to compare with the general population.MethodsA cross-sectional prospective observational study in 37 consecutive SSc in a EUSTAR cohort (EUSTAR 162 center) and 37 gender and age-matched controls without SSc.A standardized oral exam meaning OHS (periodontal, dental, mucosal and microbial), oral health-related behaviors and oral HRQoL (Oral Health Impact Profile, OHIP) were evaluated in all recruited individuals, while oral manifestations such as size of oral aperture, oral dryness, manual dexterity for oral hygiene and HRQoL only in SSc.Multivariable regression analysis was done to evaluate association between SSc, oral abnormalities, oral health status and QoL.ResultsOverall, SSc had significantly reduced oral HRQoL compared with controls (p<0.05).We demonstrated lower resting salivary flow rates (p<0.05) and pH (p<0.05), reduced maximal mouth opening (p<0.05), smaller interincisal distance (p<0.05) in SSc group as compared to their controls. Moreover, despite comparable oral health-related behaviors (e.g. same level of daily tooth-brushing), the majority of SSc experienced caries (p<0.05) and presented with more periodontal disease (p<0.05) comprising periodontal pockets (pocket depth PD>3 mm) (p<0.05), clinical attachment level (CAL) ≥5.5 mm (p<0.05).Finally, SSc was documented as a significant independent predictor of OHIP, missing teeth, periodontal disease, interincisal distances as shown by multivariate regression (p<0.05).ConclusionsSSc patients are at risk to develop impaired oral health and oral HRQoL compared with the general population.Disclosure of InterestNone declared