Treatment of orthognathic problems related to scleroderma

Scleroderma is a generalized disorder characterized by abnormalities of the small arteries and vasculature resulting in thickening and prominent fibrosis of the affected tissues. Its etiology remains uncertain. All connective tissue and certain internal organs, notably the gastrointestinal tract, heart, lung, and kidneys, as well as skin, are typically involved. Mandibular movement can become severely restricted when the facial skin is affected, sometimes resulting in secondary changes to both the mandible itself and the temporomandibular joint. We present 2 cases in which we improved facial aesthetics and mandibular function by surgically correcting malocclusion with a Le Fort I osteotomy and maxillary intrusion in patients with manifestations of scleroderma in the face and neck.