%0 Journal Article
%T Severe Osteolysis of the Mandibular Angle and Total Condylolysis in Progressive Systemic Sclerosis
%A Amin Rahpeyma
%A Seyed Hosein Hoseini Zarch
%A Saeedeh Khajehahmadi
%J Case Reports in Dentistry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/948042
%X Progressive systemic sclerosis is an autoimmune disease characterized by gradual deposition of abnormal collagen which causes fibrous changes of the skin and visceral organs such as lung, heart, and kidney, which lead to serious complication. Microangiopathy and firm skin cause extrinsic pressure and obliteration of the vessels that lead to ischemia and destruction of the underlying bone. Salivary gland fibrosis causes xerostomia that increases risk of dental caries. Therefore, oral hygiene instruction (OHI) and preventive dentistry are recommended for these patients. We present a 36-year-old female that suffers from systemic sclerosis with total lysis of the mandibular condyle. 1. Introduction Scleroderma or progressive systemic sclerosis (PSS) was first reported in 1752 by Curzio of Naples [1]. PSS, also known as scleroderma, is a connective tissue disorder characterized by fibrosis of the skin and visceral organs [2]. The cause of PSS is immunologically mediated pathogenesis. PSS occurs predominately in the adult but it can also be seen in childhood, with females affected three to four times as often as males [3]. The most common manifestations is microstomia that causes a limitation of opening the mouth in two-thirds of the cases. In addition, salivary gland fibrosis causes xerostomia; therefore, these patients are more prone to dental decay. In some patients, as loss of attachment gingival occurs, multiple area of gingival recession may be present. In scleroderma patients, preventive care is of foremost importance. Meticulous oral hygiene must be established and maintained. Occasionally slight bilateral erosion of mandibular condyle causes anterior open bite. Bone resorption is caused by the increased pressure associated with the deposition of collagen. Bone resorption has been reported in maxillofacial region, which occurs in masticatory muscle attachments [4]. On radiographic appearance a characteristic resorption of the ramus and condyle may be observed. We reported a case of total osteolysis of the mandibular condyle in a 36-year-old female patient with oral manifestations of the disease. 2. Case Report A 36-year-old female suffering from PSS with 9-year history of disease was referred to oral and maxillofacial surgery for extraction of her decayed posterior teeth. The patient had reduced maximal interincisal opening (MIO = 12£żmm), mask-like face, perioral deep rhytides, pinched nose, facial telangiectasia, and atrophic ulcerated finger tips (sclerodactyly). Pain accompanying bone resorption is present in her fingers (painful digital ischemia).
%U http://www.hindawi.com/journals/crid/2013/948042/