PDF(Pubmed)
Abstract：
OBJECTIVE: oral alterations in Systemic Sclerosis (SSc) patients are widespread and include microstomia, periodontitis, telangiectasias, mandibular resorption, bone lesions, and xerostomia. This cross-sectional study aims to evaluate the differences between SSc patients (cases) and healthy subjects (controls) regarding oral manifestations, quality of life (QoL), and microcirculation alterations.
METHODS: plaque index (PCR), periodontal index (PSR), DMFT, salivary flow rate, and buccal opening were measured by expert clinicians. S-HAQ test, the Self-Rating Anxiety State (SAS), the Self-Rating Depression Scale (SDS), and the WHOQOL-BREF test were administered to patients to evaluate their QoL. Microvascular alterations were assessed by oral videocapillaroscopy, performed on gingival and labial mucosa. A statistical analysis was conducted to find significant differences between healthy people and SSc patients.
RESULTS: 59 patients were enrolled in this study. Standard salivary flow is significantly more frequent in controls, while xerostomia, reduced flow, microstomia, lip retraction, and periodontitis are significantly more frequent in the cases. Gingival capillaroscopy showed differences concerning loop visibility, thickening of the gum, tortuosity of gingival loops, and reduced gingival density. Labial capillaroscopy demonstrates that visibility of the labial loops, the labial ectasias, and the tortuosity of the loops are significantly associated with the presence of scleroderma. Hand and facial deformities, hypomobility of the tongue, cheeks, lips, microstomia, and xerostomia significantly compromised the quality of life of SSc patients, which was significantly worse among them. Moreover, oral videocapillaroscopy could be a proper diagnostic method to detect oral microcirculation alterations. SSc patients often present ectasias, rarefaction of the reticulum, microhemorrhages, and megacapillaries, which negatively impact their oral health.
CONCLUSIONS: periodontitis, reduced salivary flow, and microstomia could be considered SSc oral manifestations. Joint deformities, facial appearance, and comorbidities significantly reduce the QoL of SSc patients compared to healthy subjects. Oral videocapillaroscopy could be an innovative and reliable technique to detect oral microcirculation anomalies.
METHODS: plaque index (PCR), periodontal index (PSR), DMFT, salivary flow rate, and buccal opening were measured by expert clinicians. S-HAQ test, the Self-Rating Anxiety State (SAS), the Self-Rating Depression Scale (SDS), and the WHOQOL-BREF test were administered to patients to evaluate their QoL. Microvascular alterations were assessed by oral videocapillaroscopy, performed on gingival and labial mucosa. A statistical analysis was conducted to find significant differences between healthy people and SSc patients.
RESULTS: 59 patients were enrolled in this study. Standard salivary flow is significantly more frequent in controls, while xerostomia, reduced flow, microstomia, lip retraction, and periodontitis are significantly more frequent in the cases. Gingival capillaroscopy showed differences concerning loop visibility, thickening of the gum, tortuosity of gingival loops, and reduced gingival density. Labial capillaroscopy demonstrates that visibility of the labial loops, the labial ectasias, and the tortuosity of the loops are significantly associated with the presence of scleroderma. Hand and facial deformities, hypomobility of the tongue, cheeks, lips, microstomia, and xerostomia significantly compromised the quality of life of SSc patients, which was significantly worse among them. Moreover, oral videocapillaroscopy could be a proper diagnostic method to detect oral microcirculation alterations. SSc patients often present ectasias, rarefaction of the reticulum, microhemorrhages, and megacapillaries, which negatively impact their oral health.
CONCLUSIONS: periodontitis, reduced salivary flow, and microstomia could be considered SSc oral manifestations. Joint deformities, facial appearance, and comorbidities significantly reduce the QoL of SSc patients compared to healthy subjects. Oral videocapillaroscopy could be an innovative and reliable technique to detect oral microcirculation anomalies.
摘要：
目的：系统性硬化症（SSc）患者的口腔改变很普遍，包括微口腔，牙周炎,毛细血管扩张,下颌吸收，骨病变,还有口干症.这项横断面研究旨在评估SSc患者（病例）和健康受试者（对照）在口腔表现方面的差异，生活质量（QoL），和微循环改变。
方法：菌斑指数（PCR），牙周指数(PSR),DMFT,唾液流速,和口腔开口由专家临床医生测量。S-HAQ试验,自我评估焦虑状态(SAS)，抑郁自评量表(SDS)，并对患者进行WHOQOL-BREF测试以评估其QoL。通过口腔视频导管镜检查评估微血管改变，在牙龈和唇粘膜上进行。进行统计分析以发现健康人与SSc患者之间的显着差异。
结果：59例患者纳入本研究。标准唾液流量在对照组中明显更频繁，而口干症,减少流量,微小口腔,唇缩,在这些病例中，牙周炎明显更常见。牙龈毛细血管镜检查显示有关环可见性的差异，口香糖的增稠，牙龈环的弯曲，牙龈密度降低。阴唇毛细管镜检查显示阴唇环的可见性，阴唇扩张，环的弯曲与硬皮病的存在显着相关。手和面部畸形，舌头的缺乏性，脸颊,嘴唇,微小口腔,口干症严重影响了SSc患者的生活质量，其中严重得多。此外，口腔视管镜检查可能是检测口腔微循环改变的正确诊断方法.SSc患者常出现扩张，网状的稀疏，微出血,和巨毛细血管，这对他们的口腔健康产生了负面影响。
结论：牙周炎，唾液流量减少，和微小口腔可被认为是SSc口腔表现。关节畸形,面部外观,与健康受试者相比，合并症显着降低了SSc患者的QoL。口腔视频镜检查可能是检测口腔微循环异常的创新且可靠的技术。
方法：菌斑指数（PCR），牙周指数(PSR),DMFT,唾液流速,和口腔开口由专家临床医生测量。S-HAQ试验,自我评估焦虑状态(SAS)，抑郁自评量表(SDS)，并对患者进行WHOQOL-BREF测试以评估其QoL。通过口腔视频导管镜检查评估微血管改变，在牙龈和唇粘膜上进行。进行统计分析以发现健康人与SSc患者之间的显着差异。
结果：59例患者纳入本研究。标准唾液流量在对照组中明显更频繁，而口干症,减少流量,微小口腔,唇缩,在这些病例中，牙周炎明显更常见。牙龈毛细血管镜检查显示有关环可见性的差异，口香糖的增稠，牙龈环的弯曲，牙龈密度降低。阴唇毛细管镜检查显示阴唇环的可见性，阴唇扩张，环的弯曲与硬皮病的存在显着相关。手和面部畸形，舌头的缺乏性，脸颊,嘴唇,微小口腔,口干症严重影响了SSc患者的生活质量，其中严重得多。此外，口腔视管镜检查可能是检测口腔微循环改变的正确诊断方法.SSc患者常出现扩张，网状的稀疏，微出血,和巨毛细血管，这对他们的口腔健康产生了负面影响。
结论：牙周炎，唾液流量减少，和微小口腔可被认为是SSc口腔表现。关节畸形,面部外观,与健康受试者相比，合并症显着降低了SSc患者的QoL。口腔视频镜检查可能是检测口腔微循环异常的创新且可靠的技术。
