Mandibular condylosis and apertognathia as presenting symptoms in progressive systemic sclerosis (scleroderma)

Scleroderma and the Temporomandibular Joint: Reconstruction in 2 Variants

“…Marmary et al 25 were unable to establish any correlation between the 2, but the evaluation by Wood and Lee 38 of 31 patients indicated more frequent TMJ involvement in patients with 34 in 1987 commented that the number of studied cases at that point was simply too few to allow derivation of any correlations between TMJ lysis and the other findings in SSc. The 2 present cases reflect the dilemma: the degree of osteolysis in the patient with mild dcSSc was as severe as that of the patient with fatal disease.…”

“…Multiple researchers have commented on the causes of condylar loss. 12,16,19,20,22,[24][25][26]30,[32][33][34] Consensus favors a combination of factors, including ischemia based on vasospasm, intense vasculitis, compression secondary to perivascular fibrosis, and direct functional stress on the condylar head. Ramon et al, 34 citing several anatomic investigators, noted that the vasculature off the maxillary artery to the condyle, coronoid process, mandibular angle, and masseteric and pterygoid muscles is finer than that to the other structures of the maxillomandibular apparatus and thus might more likely provoke SSc-induced ischemia and destruction at those sites.…”

Clinical and radiographic study of orofacial alterations in patients with systemic sclerosis

“…6,17,18 Moreover, some patients with the disease for a long time may present only slight degrees of osteolysis, while others who have just had the disease for a short time may present great destruction. 8 Concerning the presence/absence of teeth, the results showed that this was unrelated to the presence of osteolysis. That is, osteolysis may develop both in patients with a full set of teeth and in those with only a partial set (p > 0.999).…”

“…1,3 The orofacial manifestations include stiffness and atrophy of the facial skin that gives the face a mask-like appearance; progressive limitation of mouth opening; skin and mucosa pigmentation (melanoleukoderma) and telangiectasia; hardening and loss of elasticity of the oral mucosa; hardening of the tongue and soft palate; varying degrees of xerostomy; periodontitis; and diffi culty in chewing, speaking and swallowing. [6][7][8][9][10] Radiographically, some characteristic alterations caused by systemic sclerosis are observed in the maxillomandibular complex, such as thickening of the periodontal ligament and areas of osteolysis in the mandible. These areas coincide with the insertion zones of the lateral pterygoid, temporal and, particularly, the masseter muscle.…”

Unilateral temporomandibular joint ankylosis with contralateral aplasia

“…Although the cause is unknown, condylar resorption has been associated with rheumatoid arthritis, systemic lupus erythematosis, steroid usage, trauma, neoplasia, orthodontic treatment, and orthognathic surgery. [5678910] In most cases, however, there is no identifiable precipitating event,[11] and hence the term idiopathic condylar resorption. This condition appears to have a predilection for females in the age range of 15-35 years with preexisting TMJ dysfunction and high mandibular plane angle.…”