1 Department of Oral Surgery, School of Dentistry, University of Birmingham , Birmingham , UK.
2 Department of Radiology, Birmingham Dental Hospital , Birmingham , UK.
Dentomaxillofac Radiol. 2018 Feb;47(3):20170374. doi: 10.1259/dmfr.20170374. Epub 2017 Dec 15.
Scleroderma is an uncommon connective-tissue disease, its key feature being excessive collagen deposition resulting in fibrosis of the skin and internal organs. There are different types that can vary in severity from localized scleroderma to systemic sclerosis. Various clinical and radiographic findings can be attributed to the disease, which arise owing to the progressive nature of microvascular changes and collagen deposition. These include limited mouth opening, xerostomia, periodontal disease and cardiac and pulmonary disease. Whilst bone resorption has been reported, as far as we are aware, the literature has not described a case with failure of bony suture closure. Hence, we would like to describe what is probably a unique case of a patient with a 5-year history of systemic sclerosis, who was referred for management of increased mobility of her upper central incisors. Radiographic imaging (conventional and three-dimensional) confirmed increased bone resorption, partly owing to periodontal disease, but also owing to an open premaxillary suture. Similarly, other craniofacial sutures were diagnosed as being open, and, to our knowledge, this represents a yet undescribed finding in a patient suffering from scleroderma.
硬皮病是一种罕见的结缔组织疾病，其主要特征是过度的胶原蛋白沉积，导致皮肤和内脏器官纤维化。有不同类型的硬皮病，从局限性硬皮病到系统性硬皮病，严重程度不一。由于微血管变化和胶原蛋白沉积的进行性，该病会导致各种临床和影像学表现，包括张口受限、口干、牙周病以及心脏和肺部疾病。虽然已经报道了骨质吸收，但据我们所知，文献中尚未描述过一例骨缝闭合失败的病例。因此，我们想描述一下可能是一个独特的病例，一名系统性硬皮病患者，病史 5 年，因上颌中切牙活动度增加而就诊。影像学（常规和三维）检查证实了骨质吸收增加，部分原因是牙周病，但也与上颌骨缝未闭有关。同样，其他颅面缝也被诊断为未闭，据我们所知，这在患有硬皮病的患者中是一种尚未描述的发现。
