Systemic Sclerosis and Microstomia in Dentistry

Questions and Answers

What is a common treatment for Raynaud’s phenomenon in systemic sclerosis?

Immunosuppressants

Calcium channel blockers (correct)

Insulin therapy

Antibiotics

Which condition is characterized by anti-centromere antibodies?

CREST syndrome (correct)

Systemic lupus erythematosus

Primary biliary cholangitis

Rheumatoid arthritis

What is a potential complication associated with systemic sclerosis?

Osteoporosis

Hyperthyroidism

Pulmonary complications (correct)

Type 1 diabetes mellitus

Which symptom is NOT associated with CREST syndrome?

Renal failure Signup and view all the answers

How does microstomia affect dental treatment?

It complicates oral hygiene Signup and view all the answers

What condition features telangiectasia among its clinical signs?

Systemic sclerosis Signup and view all the answers

Which treatment can aid in managing oral hygiene issues caused by microstomia?

Hinged or sectional complete dentures Signup and view all the answers

What is often avoided to help manage Raynaud’s phenomenon?

Smoking Signup and view all the answers

What are the characteristic symptoms of Rheumatic Fever?

Fever, carditis, and migratory polyarthritis Signup and view all the answers

What is a complication of Rheumatic Fever?

Mitral valve stenosis Signup and view all the answers

What is the name of the antibody associated with Systemic Sclerosis?

Anti-topoisomerase I Signup and view all the answers

What is the characteristic skin feature of Systemic Sclerosis?

Smooth, hard skin texture Signup and view all the answers

What is the characteristic facial feature of Systemic Sclerosis?

Mouse-like facies Signup and view all the answers

What is the characteristic dental feature of Systemic Sclerosis?

Resorption of ramus angle Signup and view all the answers

What is the sex predilection of Systemic Sclerosis?

F>M Signup and view all the answers

What is a characteristic laboratory feature of Systemic Sclerosis?

Presence of anti-topoisomerase I antibody Signup and view all the answers

What is the primary cause of Type 1 Diabetes Mellitus?

Deficiency in insulin secretion due to autoimmune destruction of pancreatic beta cells Signup and view all the answers

Which of the following is NOT a common clinical feature of Type 1 Diabetes Mellitus?

Obesity prior to diagnosis Signup and view all the answers

Which of the following genetic factors is primarily linked to Type 1 Diabetes Mellitus?

Genes related to MHC Class I and II Signup and view all the answers

What is the primary cause of Diabetic Nephropathy?

Damage to blood vessels in the kidneys due to high blood sugar levels Signup and view all the answers

What is the characteristic appearance of oral lesions in lupus erythematosus?

Lichenoid or nonspecific Signup and view all the answers

Which of the following is a macrovascular complication associated with Diabetes Mellitus?

Atherosclerosis Signup and view all the answers

What is the role of the immune system in the development of Type 1 Diabetes Mellitus?

The immune system directly attacks and destroys insulin-producing cells in the pancreas Signup and view all the answers

In discoid lupus erythematosus, what is frequently observed alongside oral lesions?

Concurrent skin lesions Signup and view all the answers

Which of the following is a microvascular complication associated with Diabetes Mellitus?

Diabetic Retinopathy Signup and view all the answers

What mechanism contributes to tissue damage in autoimmune conditions like lupus?

Autoantibody-mediated damage or immune complex deposition Signup and view all the answers

What type of deposition is associated with lupus in terms of immune response?

Shaggy IgG deposition at the basement membrane zone Signup and view all the answers

Why is impaired wound healing a common complication of Diabetes Mellitus?

Diabetes reduces blood flow to the affected area, delaying healing Signup and view all the answers

Which of the following is NOT a common complication due to autoimmune responses in lupus?

Pneumonia Signup and view all the answers

Which of the following features is commonly associated with cutaneous lupus erythematosus?

Photosensitivity and facial butterfly rash Signup and view all the answers

Genetic factors in lupus propensity often relate to which of the following?

Familial tendencies among certain populations Signup and view all the answers

Lupus cheilitis primarily affects which part of the body?

Lips Signup and view all the answers

What is a common treatment modality for mild cases of lupus erythematosus?

NSAIDs and antimalarials Signup and view all the answers

Which factor is generally NOT considered a common characteristic of rheumatoid arthritis?

Variable joint involvement Signup and view all the answers

What is a potential prognosis for individuals with Chronic Cutaneous Lupus Erythematosus (CCLE)?

Possible remission but transformation into SLE may occur Signup and view all the answers

Which autoimmune disorder primarily attacks the joints and may also affect various organs such as skin and lungs?

Rheumatoid arthritis Signup and view all the answers

Which of the following describes a characteristic of systemic lupus erythematosus (SLE)?

There is a 75% survival rate after 20 years Signup and view all the answers

What is a common symptom associated with rheumatoid arthritis?

Fatigue and muscle weakness Signup and view all the answers

Which of the following conditions can be included in the differential diagnosis for lichenoid lesions?

Graft-versus-host disease Signup and view all the answers

What is the primary immune cell involved in the inflammatory response seen in rheumatoid arthritis?

CD4+ T helper cells Signup and view all the answers

Study Notes

Microstomia and Systemic Sclerosis

Systemic sclerosis is treated with medications like penicillamine and corticosteroids.
Raynaud's phenomenon associated with systemic sclerosis is managed using calcium channel blockers; patients should avoid cold exposure and smoking.
Patients often experience microstomia, complicating oral hygiene and dental treatments.
Prognosis for systemic sclerosis is poor due to potential pulmonary, renal, and cardiac complications.

CREST Syndrome

Considered a mild variant of limited systemic sclerosis.
Key features include:
- Calcinosis cutis
- Raynaud's phenomenon
- Esophageal dysfunction
- Sclerodactyly
- Telangiectasia
Associated with anti-centromere antibodies.

Lupus Erythematosus

Oral manifestations can appear lichenoid or nonspecific; concurrent skin lesions often seen in discoid lupus erythematosus (DLE).
Lupus cheilitis may occur.
Treatment includes avoiding sun exposure and using NSAIDs or antimalarials for mild cases; severe cases may require systemic immunosuppressive therapy.
Prognosis varies:
- Systemic lupus erythematosus (SLE) has a 20-year survival rate of 75%.
- Chronic cutaneous lupus erythematosus (CCLE) has a better prognosis, with potential for remission but risk of transforming into SLE.

Differential Diagnoses for Lichenoid Lesions

Include:
- Lichen planus
- Lichenoid drug eruption
- Lichenoid reaction to amalgam
- Chronic ulcerative stomatitis
- Lupus erythematosus
- Graft-versus-host disease
- Lichenoid dysplasia

Rheumatoid Arthritis

Chronic inflammatory autoimmune disorder affecting ~1% of the U.S. population, primarily joints but can involve skin, heart, blood vessels, and lungs.
More common in females, with genetic and environmental factors influencing onset.
Activated CD4+ T helper cells release cytokines, leading to inflammation and destruction of bone and cartilage.
Symptoms include fatigue, weakness, symmetrical joint involvement, and stiffness, especially in hands, feet, and knees.

Diabetes Mellitus

Two main types:
- Type 1: Autoimmune destruction of pancreatic β cells; common in childhood/adolescence; associated with islet autoantibodies.
- Type 2: Insulin resistance in adulthood; linked with obesity and no islet autoantibodies.
Common complications include diabetic nephropathy, retinopathy, neuropathy, impaired wound healing, and increased infection risk.

Rheumatic Heart Disease

Develops post-streptococcal infection; manifests as fever, carditis, migratory polyarthritis, and erythema marginatum.
No longer indicates antibiotic prophylaxis for dental treatments to prevent infective endocarditis.

Systemic Sclerosis (Scleroderma)

Affects females more frequently.
Characterized by smooth, hard skin texture, mouse-like facies, and dense collagen deposition.
Associated lab finding: anti-Scl 70 (antitopoisomerase I) antibodies.
Significant complication includes Raynaud's phenomenon and resorption of the ramus angle.

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Description

This quiz covers the treatment and dental implications of systemic sclerosis, including microstomia, and its complications. It also touches on the use of hinged and sectional complete dentures for restricted mouth opening.