Abstract
Systemic sclerosis (SSc) is a relatively rare condition with an immunologically mediated pathogenesis. For reasons that are not clearly understood, dense collagen is deposited in the connective tissues of the body in extraordinary amounts. Although its dramatic effects are seen in association with the skin, the disease is often quite serious with visceral organ involvement. We describe a case of limited mouth opening secondary to diffuse SSc, improvement in mouth opening with passive jaw stretch exercises, and the challenges involved in performing dental procedures for such patients.
Highlights
Systemic sclerosis (SSc) or scleroderma is an incurable and potentially life-threatening systemic autoimmune connective tissue disease of unknown etiology and multifactorial pathogenesis characterized by cutaneous and visceral fibrosis, microvascular obliteration, and highly specific serum autoantibodies to nuclear autoantigens [1, 2]
This paper describes a case of limited mouth opening secondary to diffuse SSc, improvement in mouth opening with passive jaw stretch exercises, and the challenges involved in performing dental procedures for such patients
The pathogenesis of SSc has not been fully elucidated yet, the fibrosis is characterized by the excessive accumulation of extracellular matrix proteins in the skin and viscera with vascular injury and immunological abnormalities
Summary
Systemic sclerosis (SSc) or scleroderma is an incurable and potentially life-threatening systemic autoimmune connective tissue disease of unknown etiology and multifactorial pathogenesis characterized by cutaneous and visceral fibrosis, microvascular obliteration, and highly specific serum autoantibodies to nuclear autoantigens [1, 2]. SSc is divided into diffuse cutaneous, and limited cutaneous forms based on the extent of skin involvement. Orofacial tissue involvement is a typical feature in patients suffering from SSc; the subject’s face becomes expressionless, the cutaneous furrows disappear, and the nose becomes sharp. The alterations in facial form include decreased mouth opening (microstomia). This may interfere considerably with eating, speaking, oral hygiene measures, and dental treatment, deteriorating the quality of life of these subjects [4, 5]. This paper describes a case of limited mouth opening secondary to diffuse SSc, improvement in mouth opening with passive jaw stretch exercises, and the challenges involved in performing dental procedures for such patients
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