Restoring Mouth Opening in Systemic Sclerosis: A Scoping Review of Interventions

Area of Science:

• Rheumatology
• Dermatology
• Oral Medicine

Background:

• Microstomia is a common complication of systemic sclerosis, significantly impacting quality of life.
• Limited understanding exists regarding the comprehensive landscape of therapeutic strategies for managing microstomia in systemic sclerosis patients.

Purpose of the Study:

• To systematically map and characterize existing therapeutic strategies for microstomia management in systemic sclerosis.
• To identify gaps and heterogeneity in the current literature on microstomia treatments.

Main Methods:

• A scoping review was conducted following PRISMA-ScR guidelines.
• Searches encompassed major databases (Medline/PubMed, Embase, Scopus, Web of Science, Cochrane Library) and gray literature.
• Included studies focused on adult systemic sclerosis patients with interventions for microstomia and reported mouth opening outcomes.

Main Results:

• Forty-five studies were included, predominantly featuring non-surgical interventions (physiotherapy, injectables, oral medications).
• Surgical treatments, mainly autologous fat grafting, were less common.
• Evidence primarily consists of conservative interventions in randomized controlled trials and surgical approaches in quasi-experimental studies, with significant heterogeneity observed.

Conclusions:

• Current evidence for microstomia management in systemic sclerosis relies heavily on non-surgical approaches and exhibits considerable methodological heterogeneity.
• Standardized outcome measures, extended follow-up periods, and robust multicenter studies are crucial for future research.
• Further investigation is needed to clarify the roles of both conservative and surgical treatments.