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FRI0103 The oral involvement in scleroderma (systemic sclerosis)
  1. F Gharibdoost,
  2. M Sahebjami,
  3. M Khoshkhoonedjad,
  4. M Akbarian,
  5. F Shahram,
  6. A Nadji,
  7. AR Jamshidi,
  8. C Chams,
  9. F Davatchi
  1. Rheumatology Research Center, Shariati Hospital, Tehran, Iran

Abstract

Background Oral manifestations are a common feature of systemic sclerosis (scleroderma).

Objectives The aim of this study was to find the frequency, characteristics, and the severity of oral involvement in Iranian patients with scleroderma, seen in the Scleroderma Unit, Rheumatology Research Centre.

Methods Cases were selected consecutively according to the American Colledge of Rheumatology criteria.

A complete oral examination was performed for all patients. Their data were compared with a control group by chi square test and fisher exact test.

Results Forty scleroderma (Scl) patients (31 limited scleroderma, 9 diffuse form) and 40 healthy subjects (age and sex matched) were evaluated.

The mean age in the Scl group was 40.83 (± 10.02 SD) and in the control group 40.30 (+ 10.43 SD) years.

The mean duration of the disease was 8.3 (± 8.94 SD) years.

The following sympotoms were seen more frequently in Scl than in the control group: reduced vertical lip distance (40.25 mm ± 7.26 SD versus 49.63 mm ± 7.38SD, p < 0.0005), Xerostomy (subjective,%35 versus%75, P = 0.003), Raynaud’s of oral region (27.5% vs. 5%, p < 0.0001). The number of lost teeth (due to mobility or decays) was 9.59 ± 9.73 SD versus 4.3 ± 6.54SD (p = 0.006). Stiffness and depapillation of the tongue was 35% vs. 0% (each sign) (p < 0.0005). Gingival Inflammation was 77.5% vs. 42.5% (p = 0.001). The atrophy of gingival surface (thin epithelium) was 70% vs. 2.5% (p < 0.0005). Gingival stiffness was 30% vs. 0% (p < 0.0005). Flattening and disappearance of the mucosal folds in the ruga region (on the hard palate) was 35% vs. 0% (p < 0.0005). Gingival recessions were 42.5% vs. 2.5% (p < 0.0005). Oral mucosal involvements (via clinical examination of regions in the oral cavity) including mucosal atrophy and thinning were seen more frequently in Scl than in normal controls (p < 0.0005). The same was true for mucosal pallor (p = 0.002), mucosal telangiectasia (p < 0.0005), mucosal erosions and ulcerations (p = 0.002).

Conclusion Systemic sclerosis frequently involves different parts of the oral cavity. The teeth, tongue, gengiva and mucosal folds involvement were seen more than normal population. We recommend oral examination regularly in patients with scleroderma.

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