What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases

Abstract

Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

Correlation Between the Oral Manifestations of Rheumatoid Arthritis Patients on Different Treatments with The Clinical Disease Activity

“…The results also showed that the larger number of RA patients with TMJ disorders having a high CDAI (13 patients) and moderate CDAI (13 patients) this was consistent with Moen et al, (2005) [31] who related the salivary dysfunction and TMJ disorders to an increased disease activity. Bishu et al,in (2014) [26] stated that the presence of β-1,3-glucan, which is an antigen found in the candidal cell wall can increase the activity of RA clinically.…”

Association between oral lesions and disease activity in lupus erythematosus

“…43,44 A large number of studies have shown that periodontitis is associated with elevated levels of CRP and other inflammatory biomarkers. 27 In addition, periodontal treatment is associated with an improvement in endothelial function, with a decrease in local and systemic inflammatory processes. 27 In addition, periodontal treatment is associated with an improvement in endothelial function, with a decrease in local and systemic inflammatory processes.…”

“…4,9,10,12,13,17,18,[20][21][22][24][25][26][27][28][29][30][31][32][33] Thus, in contrast to cutaneous lupus lesions, no uniformity exists in classifying oral lesions. Clinical descriptions of oral lupus lesions vary enormously in the different studies, and the terminology used to describe oral lesions in the scientific literature in patients with lupus is somewhat imprecise and varied, highlighting the following: 'lupus cheilitis', 'chronic plaques', 'oral discoid lesions', 'honeycomb plaques', 'lichen planus-like lesions', 'keratotic lesions', 'ulcerative plaques', 'oral ulcers', 'erythematous patches', 'pebbly red areas', 'purpuric lesions', enanthema and 'diffuse palatal petechial erythema'.…”

Funções orofaciais em portadores de síndrome de Sjögren

“…A DTM geralmente, afeta mais as mulheres, na terceira década de vida e os principais sintomas relatados são: dificuldade para movimentar a boca, dor nos músculos da mastigação e ATMs, cansaço e dor para realizar funções estomatognáticas, como por exemplo, falar e mastigar, ruído nas articulações e dor que pode irradiar para cabeça e região cervical (Bataglion e Bataglion, 2009 (Hoyuela et al, 2015;Abrão et al, 2016).…”

“…Embora a frequência de problemas na ATM em pacientes com AR relatada na literatura seja bastante variável (4,7-85%) (Hoyuela et al, 2015;Abrão et al, 2016), em um estudo recente, Hoyuela et al (2015) (Pierce et al, 2016;Eyigör et al, 2017).…”