La diagnosi precoce della sclerosi sistemica progressiva

Abstract

BACKGROUND: The study considers the oro-facial manifestations occurring in a group of patients suffering from progressive systemic sclerosis, evaluating their predictive role and monitoring the systemic disease. METHODS: 34 patients with systemic sclerosis were examining: 30 women, 4 men, at the Department of Dental Sciences, Palermo University, from July 1998 to March 2001. All patients were positive for the diagnostic criteria of scleroderma.1 For each patient we considered: observation of any changes in soft tissues of the oral cavity; evaluation of possible xerostomia; evaluation of any fungal infections; presence of prosthetic sores in patients wearing dentures; DMFS evaluation; evaluation of periodontal health; evaluation of bone resorption. RESULTS: One of the most interesting results was that: in 4 patients, medical history contained past trigeminal sensory neuropathy characterised by the slow and gradual numbness of the face muscles, which developed into pain and paresthesia, weakening or disappearance of the sense of taste and in one case loss of sensitivity at the oro-pharynx (this progression of symptoms preceded by three years the onset of systemic manifestations, and consequently diagnosis); 14 patients as first sign of the disease had a "hardening" of the skin of the face with consequent microstomia with marked difficulty in speaking. CONCLUSIONS: The most significant result emerging from this study was the predictive role of progressive systemic sclerosis, that can be played by some oro-facial manifestations; an important element which has recently changed the life expectation for scleroderma patients is the possibility of diagnosing the disease in an early phase and thus bringing to bear all the therapeutic measures necessary to hinder development of the disease and its consequences.