Orofacial consequences of systemic sclerosis: A systematic review

Area of Science:

• Oral medicine
• Rheumatology
• Systemic sclerosis research

Background:

• Orofacial manifestations are common in systemic sclerosis but often overlooked in clinical guidelines.
• These issues significantly affect patients' quality of life, impacting comfort, nutrition, aesthetics, and self-confidence.

Purpose of the Study:

• To comprehensively review and describe the diverse orofacial consequences of systemic sclerosis.
• To highlight the importance of early diagnosis and management of these oral manifestations.

Main Methods:

• Systematic literature search across four major databases (PubMed, Cochrane, SCOPUS, Dentistry & Oral Sciences Source) up to December 2016.
• Inclusion of grey literature and hand-searched articles, focusing on studies with at least 30 systemic sclerosis patients and oropharyngeal examination.
• Data extraction and risk bias assessment (Newcastle-Ottawa scale) conducted by two independent reviewers.

Main Results:

• Identified key orofacial features: microstomia, xerostomia with hyposialia, temporomandibular joint symptoms, high caries experience, and periodontal diseases.
• An increased risk of oral cavity and pharyngeal cancers was noted in patients with systemic sclerosis.
• Early diagnosis and intervention are essential for effective management.

Conclusions:

• Systemic sclerosis presents significant orofacial challenges that necessitate greater attention in clinical practice.
• Proactive oral hygiene and early management can prevent severe complications and the need for invasive procedures.
• Further high-level evidence studies are required to establish standardized treatment protocols.