Periodontal manifestations of collagen vascular disorders

Abstract

Chronic degeneration of connective tissue components can be produced by a variety of autoimmune mechanisms. The designations connective tissue disease and collagen-vascular disease are commonly used to describe such conditions when a patient exhibits chronic, immune-mediated deterioration of connective tissue structures in a systemic distribution. Recognized conditions that fit this definition include rheumatoid arthritis, lupus erythematosus, progressive systemic sclerosis, CREST syndrome, and mixed connective tissue disease. Several characteristic oral manifestations of these conditions are recognized. Xerostomia associated with any of these conditions in addition to dryness of the eyes is the definition of secondary Sjögren's syndrome. Fibrosis of facial skin and the resulting limited jaw opening are diagnostic features of progressive systemic sclerosis. Several periodontal manifestations are associated with these connective tissue disorders. Dramatic periodontal ligament space widening that is associated with some cases of progressive systemic sclerosis has been appreciated for more than five decades. However, it has been more recently reported that the majority of progressive systemic sclerosis patients exhibit at least subtle generalized periodontal ligament widening when intraoral radiographs are carefully evaluated. This finding is, however, of limited periodontal significance because the teeth are typically not mobile. Comparisons of periodontitis indices such as pocket depth between healthy subjects and patients with progressive systemic sclerosis do not reveal significant differences (21). In addition, recent evidence suggests a tendency for more severe or progressive manifestations of periodontitis as a consequence of xerostomia that may result from these diseases.

Implants in the Medically Compromised Patient

“…4), e.g., after therapeutic head and neck irradiation (Guchelaar et al, 1997;Fox, 1998), autoimmune diseases (Gonzales and Coleman, 1999) such as Sjögren's syndrome (Boutsi et al, 2000), systemic lupus erythematosus (Rhodus and Johnson, 1990), progressive systemic sclerosis (Osial et al, 1983;Wood and Lee, 1988), primary or secondary amyloidosis (al Hashimi et al, 1987;Richey and Bennion, 1996), sarcoidosis (Drosos et al, 1989;Sack et al, 1998), infectious diseases such as HIV (Kordossis et al, 1998) andhepatitis C (al Hashimi, 2001), or diabetes mellitus (Darnell and Saunders, 1990;Rees, 2000), and can be induced by over 400 drugs, including tricyclic antidepressants, antihistamines, and diuretics (Sreebny and Schwartz, 1997). The most prominent causes of reduced salivary flow are therapeutic pharmaceutical side-effects (Schein et al, 1999).…”

Relationship between Hyposalivation and Acute Respiratory Infection in Dental Outpatients

“…Iwabuchi /Fujibayashi /Yamane /Imai / Nakao Gerontology 2012;58:205-211 206 7] , increased or aggravated marginal periodontitis [8] , illfitting dentures, and accompanying pain.…”

Achados bucais e laboratoriais em pacientes com lúpus eritematoso sistêmico

“…O aspecto clínico prevalente no nosso estudo correspondeu ao branco/eritematoso (46,2%), o que corrobora os achados descritos na literatura (2,5,13,19,29,30,31,36) .…”