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硬皮病:口腔、颌面和放射学表现,供牙科医生参考。

Scleroderma: oral, maxillofacial and radiographic manifestations for dental practitioners.

机构信息

Department of Dental and Maxillofacial Radiology, Royal London Dental Hospital, Turner Street, London, E1 1FR, UK; Department of Dental and Maxillofacial Radiology, Eastman Dental Hospital, 47-49 Huntley St, London, WC1E 6DG, UK.

Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 1FR, UK.

出版信息

Br Dent J. 2024 Jun;236(11):881-886. doi: 10.1038/s41415-024-7453-1. Epub 2024 Jun 14.

Abstract

Scleroderma is an autoimmune condition of unknown aetiology with a range of manifestations, which can be limited to the skin or can extend to be multisystemic. It is characterised by fibrosis, microangiopathy and dysregulation of the immune system and commonly affects the oral cavity. Frequent oral and maxillofacial features include fibrosis of the face, circumoral furrows and reduced oral aperture. Radiographic findings are often incidental, including uniform, asymptomatic periodontal ligament space widening of teeth and osteolysis of bone at muscular attachments. The oral and maxillofacial manifestations significantly contribute to its disease burden and are often overlooked and undertreated as their treatment can be limited due to their challenging rheumatological care. Given the complexity of the condition and its multisystemic impacts, better co-operation between dentists and rheumatologists may help improve this patient cohort's quality of life. This clinical article aims to better equip dentists to identify features of scleroderma and manage the day-to-day oro-facial manifestations.

摘要

硬皮病是一种病因不明的自身免疫性疾病,具有多种表现形式,既可局限于皮肤,也可扩展为多系统疾病。其特征为纤维化、微血管病变和免疫系统失调,常累及口腔。常见的口腔颌面部特征包括面部纤维化、口周皱纹和口腔开口减小。放射学表现通常为偶然发现,包括牙齿牙周韧带间隙均匀、无症状性增宽和肌肉附着处骨溶解。口腔颌面部表现显著增加了疾病负担,但往往被忽视和治疗不足,因为其治疗可能因具有挑战性的风湿病护理而受到限制。鉴于该病的复杂性及其对多系统的影响,牙医和风湿病学家之间更好的合作可能有助于提高这一患者群体的生活质量。本文旨在使牙医更好地识别硬皮病的特征,并对日常口腔颌面部表现进行管理。

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