ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 717

Dental Health in Systemic Sclerosis Patients Risk Factors and Comorbidities

Sabrina Paolino 1, Francesco Cattelan 2, Schenone Carlotta 3, Alberto Sulli 4, Andrea Casabella 5, Carmen Pizzorni 1 and Maurizio Cutolo6, 1Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, 2Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy, 3Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, genova, Liguria, Italy, 4Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Genoa, Italy, 51 Research Laboratory and Academic Division of the Clinical Rheumatology Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, 6Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Genoa, Italy

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: ,

Session Information

Date: Sunday, November 10, 2019

Title: Systemic Sclerosis & Related Disorders – Clinical Poster I

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Background: Systemic sclerosis (SSc) is a rare multisystemic autoimmune disease characterized by microvascular damage and progressive fibrosis of skin and internal organs. Global oral health in SSc may depend by skin fibrosis of oral facial region or masticatory apparatus and quality of bone that is sustaining dentition (1). Trabecular Bone Score (TBS) analysis provides an indirect measurement of microarchitecture and get information about bone quality in several rheumatic diseases such as SSc (2).

Objectives: The aim of the study was to evaluate the most frequent dental/oral alterations in a cohort of SSc patients and the relationship between dental loose and quality of bone evaluated by TBS.

Methods: 32 patients, fulfilling the ACR/EULAR 2013 criteria for SSc underwent a dual-energy X-ray absorptiometry scan (DXA) to evaluate bone mineral density and TBS. All patient performed a standard questionnaire regarding dental health

Results: Patients were 5 men (16%), 27 women (84%), mean age 60.3+8.7 years, disease duration from the first Raynaud symptoms was 13.2+4.5 years. All patients came from urban environment: 65.6% affected by limited SSc (lSSc ) and 34.4% by diffuse SSc (dSSc). Most of patients were taking immunosoppressive drugs (MTX 15%, MMF 32%, previous cyclophosfamide treatment 25%, cyclosporine 13%, RTX 6%) and 28 % were treated with only symptomatic drugs (i.e. vasodilators). Nobody was treated with bone antiresorptive drugs (bisphosphonates). Smokers were 19%.

The most frequent oral/dental alterations observed were: oral ulcers 31.3%; painful gums 46.8%; bleeding gums 37.5%; loos teeth 56.3%; dentures 66%; halitosis 46,8%; xerostomia 53.1 (sicca syndrome); swollen gums 25%; receding gums 59%; dental caries 65.6%; cewing issues 28.1%; microstomia 46.9%. The clinical evaluation looking at risk factors found: gastrointestinal involvement with dysmotility and disfagia (31%) and “claw hand” with difficult handgrip and related limited teeth brushing (19%). Most of patients (67%) presented low bone mass and osteopenia, only one case was diagnosed as true osteoporosis. Of note, no statistically differences in TBS were reported between patients with or without dental loose (1.276±0.08 vs 1.19±0.08 P=0.70).

Conclusion: SSc is associated with poor dental health with high prevalence of dental loose. Bone quality assessed by TBS do not seems to influence the unstable dentition and teeth loose; most probably the mechanism is related to ischemic bone area induced by microangiopathy as recently reported in literature (3).

1. Jung S et al. Oral Dis. 2017;23(4):424–439. 2. Ruaro B, et al. Clin Rheumatol. 2018 Nov;37(11):3057-3062. 3. Puzio A et al. Adv Clin Exp Med 2019;28(4):547-554

Disclosure: S. Paolino, None; F. Cattelan, None; S. Carlotta, None; A. Sulli, None; A. Casabella, None; C. Pizzorni, None; M. Cutolo, Boehringer, Actelion, Celgene, Bristol-Mayer Squibb, 2.

To cite this abstract in AMA style:

Paolino S, Cattelan F, Carlotta S, Sulli A, Casabella A, Pizzorni C, Cutolo M. Dental Health in Systemic Sclerosis Patients Risk Factors and Comorbidities [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/dental-health-in-systemic-sclerosis-patients-risk-factors-and-comorbidities/. Accessed .

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