Surgical orodental implications in ankylosing spondylitis

Area of Science:

• Dentistry
• Rheumatology
• Orthopedics

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by spinal and sacroiliac joint fusion.
• Limited mouth opening (trismus) is a common complication in AS patients, posing significant challenges for dental procedures.
• The temporomandibular joint and pelvic complex exhibit bidirectional relationships, relevant in conditions like AS.

Observation:

• A 39-year-old male with AS presented for impacted third molar extraction but had prior dental care rejections due to limited jaw mobility.
• Pre-surgical lateral neck radiography was performed to rule out cervical spine instability.
• The surgical procedure required careful neck support, consideration of immunosuppressive medication effects (corticosteroids), and meticulous infection control.

Findings:

• Despite challenging surgical access, the impacted third molar extraction was successfully completed without complications.
• The patient received standard post-operative care with analgesics and antibiotics.
• Impaired oral access in AS patients can lead to inadequate or delayed dental treatment.

Implications:

• Dental management in AS patients necessitates specialized care, including cautious neck and jaw support.
• Minimizing applied forces and adhering strictly to infection control protocols are essential.
• Surgical interventions for AS patients are best performed by experienced dental professionals in a controlled environment.