Mandibular condylosis and apertognathia as presenting symptoms in progressive systemic sclerosis (scleroderma). Pattern of mandibular bony lesions and atrophy of masticatory muscles in PSS, presumably caused by affected muscular arteries.

Apertognathia (open bite) is usually a developmental deformity of the jaws and the dentoalveolar segments in childhood and adolescence. The sudden insidious appearance of an open anterior bite in adult life is extremely rare and may be due to pathologic condylar fractures (with displacement) or to bilateral condylosis. To the best of our knowledge, only five cases of bilateral mandibular condylosis in progressive systemic sclerosis (PSS) have been reported in the literature, and the present article deals with the sixth known case. In the 22-year-old woman presented in this article the mandibular manifestations were the very early symptoms of PSS, which had a very rapid fatal course. A review of the literature is presented, and attention is called to the serious significance of sudden apertognathia. PSS is a chronic generalized disease of the small arterial vessels and the mesenchyme tissues of unknown origin. The musculoskeletal system is often involved, and the disease may affect the mandible, causing bony erosions, osteolysis, and atrophy of the masticatory muscles. It is believed that these bony lesions are of ischemic origin. The lesions, which are usually bilateral, occur only in the condyles, the coronoid processes, and the gonial angles. The main arterial blood supply to the mandible and to the major part of the ascending ramus originates from the inferior alveolar artery. The blood supply of the condyles, the coronoid processes, and the gonial angles originates in small muscular arteries.(ABSTRACT TRUNCATED AT 250 WORDS)