Scleroderma and the Temporomandibular Joint: Reconstruction in 2 Variants

MacIntosh, Robert Bruce; Shivapuja, Prasanna-Kumar; Naqvi, Rabia

doi:10.1016/j.joms.2014.12.012

Cited by 16 publications

(14 citation statements)

References 37 publications

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“…The management of condylar resorption ranges from conservative approaches with only functional appliances (Mugino and Ikemura, ) to maxillary and mandibular osteotomies (Haers and Sailer, ) or condylar resection (Doucet and Morrison, ) with genioplasty. Recently, the replacement of destroyed temporomandibular condyles with costochondral grafts in two SSc patients has been described with long‐term functional improvement (MacIntosh et al , ). As TMJ involvement is common in SSc patients, a careful examination (including MRI exploration when necessary) should be performed during rheumatologic assessment (Matarese et al , ).…”

Section: Oral Managementmentioning

confidence: 99%

“…Severe resorption can, in some cases, induce painful trigeminal neuropathy due to the compression of the inferior alveolar nerve (Fischoff and Sirois, 2000). Erosions of the condyles can also lead to degenerative disease of the TMJ that is frequently associated with pain and dysfunction (Haers and Sailer, 1995;Mugino and Ikemura, 2006;Doucet and Morrison, 2011;Delantoni and Matziari, 2015;MacIntosh et al, 2015).…”

Section: Oral Diseasesmentioning

confidence: 99%

“…Orofacial manifestations in systemic sclerosis S Jung et al improvement (MacIntosh et al, 2015). As TMJ involvement is common in SSc patients, a careful examination (including MRI exploration when necessary) should be performed during rheumatologic assessment (Matarese et al, 2016).…”

Section: Oral Diseasesmentioning

confidence: 99%

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The spectrum of orofacial manifestations in systemic sclerosis: a challenging management

et al. 2016

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Systemic sclerosis (SSc) is a rare multisystem connective tissue disorder characterized by the triad fibrosis, vasculopathy and immune dysregulation. This chronic disease has a significant impact on the orofacial region that is involved in more than two-thirds of the cases. SSc patients can show a wide array of oral manifestations, which are usually associated with a severe impairment of the quality of life. They often present a decreased the salivary flow and a reduced mouth opening that contribute substantially to the worsening of the oral health status. Therefore, SSc patients require specific and multidisciplinary interventions that should be initiated as early as possible. The identification of specific radiological and clinical signs at the early stage will improve the management of such patients. This study reviews the wide spectrum of orofacial manifestations associated with SSc and suggests clues for the oral management that remains challenging.

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Section: Oral Managementmentioning

confidence: 99%

Section: Oral Diseasesmentioning

confidence: 99%

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The spectrum of orofacial manifestations in systemic sclerosis: a challenging management

et al. 2016

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“…9 The most frequent oral finding to precede systemic involvement appears to be TN characterized by short recurrent episodes of intense paroxysms of pain in the regions where 1 or more branches of the trigeminal nerve are distributed; TN may involve either 1 or both sides of the face. 28 Sensory involvement is predominant in TN that rarely affects masticatory muscles. 9 Of note, TN may be the very 1 st symptom of connective tissue diseases, and awareness of this possibility may allow for early and more accurate treatment.…”

Section: Scleroderma Overlap Syndromesmentioning

confidence: 99%

Systemic sclerosis and its oral health implications

Puzio¹,

Przywara-Chowaniec²,

Postek−Stefańska³

et al. 2018

Adv Clin Exp Med

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Systemic sclerosis (SSc) is a chronic, generalized disorder of the connective tissue. It is characterized by immune disorders, abnormalities of morphology and functions of small blood vessels, and the presence of inflammatory process. The pathogenesis of this disorder has not yet been fully understood. The classification criteria were established by The American College of Rheumatology (ACR). A number of clinical types are distinguished due to the diversity of the clinical picture. These types are characterized by a different course, presence of organ complications and prognosis. Connective tissue disorders are interdisciplinary conditions and, therefore, the subject of interest of different medical specialties, including dentistry. The oral cavity may be the place of pathological manifestations within soft and hard tissues. Such manifestations are the results or the primary symptom of systemic diseases. The relationship between the health of the oral cavity and systemic diseases has been frequently reported in the literature. Lesions in the oral cavity in patients with SSc are discussed in detail in the present paper. Management includes the administration of drugs that prevent tissue ischemia and post-ischemic consequences as well as drugs that inhibit inflammatory-immune processes and excessive collagen production.

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“…Systemic manifestations of inflammatory disorders are seen in granulomatous processes such as sarcoidosis, rheumatoid arthritis, and juvenile idiopathic arthritis (85,86), where there is formation of granulomas with inflammatory cells or macrophages surrounded by lymphocytes (87). Other autoimmune diseases such as psoriatic arthritis and scleroderma may manifest with maxillofacial abnormalities (88).…”

Section: Inflammatory Disordersmentioning

confidence: 99%

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

et al. 2018

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Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications. Online supplemental material is available for this article. RSNA, 2018.

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Scleroderma and the Temporomandibular Joint: Reconstruction in 2 Variants

Cited by 16 publications

References 37 publications

The spectrum of orofacial manifestations in systemic sclerosis: a challenging management

The spectrum of orofacial manifestations in systemic sclerosis: a challenging management

Systemic sclerosis and its oral health implications

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

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