Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders

Authors

  • Letícia Cavassini Torquato Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Periodontia, São José dos Campos, SP, Brasil https://orcid.org/0000-0003-0962-156X
  • Clarissa Carvalho Martins Maciel Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Periodontia, São José dos Campos, SP, Brasil https://orcid.org/0000-0002-7058-4721
  • Nátaly Domingues Almeida Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Periodontia, São José dos Campos, SP, Brasil https://orcid.org/0000-0003-0772-6050
  • Wagner de Oliveira Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Odontologia Restauradora, Divisão da Oclusão e Articulação Temporomandibular, São José dos Campos, SP, Brasil https://orcid.org/0000-0002-7129-6211
  • Maria Aparecida Neves Jardini Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Periodontia, São José dos Campos, SP, Brasil https://orcid.org/0000-0003-3229-8019
  • Antonio Braulino de Melo Filho Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Odontologia Social e Clínica Infantil, São José dos Campos, SP, Brasil https://orcid.org/0000-0002-7794-2851
  • Sergio Lucio Pereira Castro Lopes Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Radiologia, São José dos Campos, SP, Brasil https://orcid.org/0000-0002-0882-5862
  • Andréa Carvalho De Marco Universidade Estadual Paulista, Instituto de Ciência e Tecnologia, Departamento de Diagnóstico e Cirurgia, Divisão da Periodontia, São José dos Campos, SP, Brasil https://orcid.org/0000-0002-1894-7855

DOI:

https://doi.org/10.4322/bds.2023.e3998

Abstract

Scleroderma, an autoimmune disease, directly affects the production of collagen in the connective tissue. In its systemic form, the disease causes oral manifestations such as: limited mouth opening, xerostomia, periodontal disease, thickening of the periodontal ligament and bone resorption of the mandible. This case report aims to draw attention to the difficulties encountered in providing dental care to patients with scleroderma and also to highlight the imaging findings, with emphasis on the temporomandibular joints, which are of interest to dentists about the disease. In the present case, the patient presented bilateral condylar erosion, in addition to disc displacement without reduction. Due to the systemic condition of the patient, it was decided to make an individualized occlusal splint. The limitation of mouth opening is a limiting factor for the manufacture of prostheses and plates, which is why partial prostheses are indicated and are easily removed by the patient. The decisions taken have a great impact on the health and quality of life of patients in these conditions, so there is a need for multidisciplinary involvement in order to arrive at the best treatment plan. After five years of using the stabilizing plate overnight, the patient reports greater comfort and muscle relaxation upon waking up.

KEYWORDS

Case Reports; Diagnostic imaging; Systemic scleroderma; Temporomandibular joint; Temporomandibular joint disorders.

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Published

2023-12-13

Issue

Section

Case Report or Clinical Technique