Osteolysis Affecting the Jaws in Systemic Sclerosis: Clinical and Osseous Changes Based on a Case Presentation

Abstract

OBJECTIVESThe aim of the current paper is to present a case of systemic sclerosis of the jaws with all the characteristics and some extensive findings.METHODSSystemic sclerosis is a connective tissue condition characterized by chronic inflammatory changes, presenting with a number of symptoms. The paper aims to present a case of systemic sclerosis that had some of the characteristics of the condition unilaterally. The features were prominent and well demarcated on the panoramic radiograph.RESULTSThe panoramic radiograph of the patient showed extensive condylar head resorption almost to the level of complete flattening.DISCUSSIONThe rarity of the condition and the awareness the oral radiologist must have upon presentation of similar images is the main reason for the presentation of the case. The features the case presents are both characteristic and well demarcated. Finally, the authors try to alert the clinician, who should be mindful of the fact that sclerodermatous involvement of organ systems is so pleotropic, that it may include the oral cavity, which is not always thoroughly observed, and is often left unattended by medical practitioners.

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

“…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).…”

Unusual type of scleromyxedema with multiple subcutaneous nodules, IgM-λ paraproteinemia, and scleroderma-like microangiopathy

“…In scleroderma, acroosteolysis and condylysis are supposed to be caused by vasculopathy and pressure atrophy secondary to ischemia at the attachment site of muscles. 4–6 Although scleromyxedema generally does not present vasculopathy, our patient had several symptoms related to peripheral circulatory disorders such as coldness and numbness of her hands and feet since she developed skin manifestations. The microvascular impairment revealed by skin biopsy implies dermal/subcutaneous vascular loss and occlusion in her body.…”

“…Bone resorption of the fingertips is characteristic of scleroderma, 4 and mandibles can also be affected in some cases. 5 However, no studies of scleromyxedema have reported these symptoms. In scleroderma, acroosteolysis and condylysis are supposed to be caused by vasculopathy and pressure atrophy secondary to ischemia at the attachment site of muscles.…”