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Restoring Mouth Opening in Systemic Sclerosis: A Scoping Review of Interventions
Beatriz Borba Barros Bernardo1, Lucas Nascimento Ribeiro2,3, Luiz Alcino Monteiro Gueiros4
1Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Objectives:
To map and characterize the therapeutic strategies described in the literature for the management of microstomia in patients with systemic sclerosis.
Methods:
This scoping review was conducted in accordance with the PRISMA-ScR guidelines. Searches were performed in Medline/PubMed, Embase, Scopus, Web of Science, Cochrane Library, and gray literature searches. Studies involving adults with systemic sclerosis of any subtype who received local or systemic interventions aimed at improving microstomia and reported at least one mouth opening-related outcome were eligible.
Results:
Forty-five studies were included. Non-surgical interventions predominated, including physiotherapy, injectables, and oral medications, whereas surgical treatments were less frequently reported and mainly involved autologous fat grafting. Randomized controlled trials primarily evaluated conservative interventions, while surgical approaches were mostly investigated in quasi-experimental studies. Heterogeneity was observed across study designs, outcome measures, follow-up durations, and assessment instruments. Objective measures of mouth opening, especially interincisal distance, were the most reported outcomes.
Conclusions:
The available evidence on microstomia management in systemic sclerosis is predominantly based on non-surgical interventions and is marked by substantial methodological heterogeneity. Future research should prioritize standardized outcome measures, longer follow-up periods, and well-designed multicenter studies to better define the role of conservative and surgical treatments in this clinical setting.
