The Canadian Systemic Sclerosis Oral Health Study V: Relationship Between Disease Characteristics and Oral Radiologic Findings in Systemic Sclerosis

ABSTRACT Objectives: Systemic Sclerosis (SSc) is associated with a wide periodontal ligament (PDL) and mandibular erosions. We investigated the clinical correlates of SSc with these radiologic abnormalities. Methods: Subjects from the Canadian Scleroderma Research Group cohort underwent detailed radiologic examinations. Associations between radiologic abnormalities and clinical manifestations of SSc were examined with univariate and multivariate analyses. Results: The study included 159 subjects: 90.6% were women, the mean age (+SD) was 56±10 years, diffuse disease was present in 28.3% and mean disease duration was 13.7 ± 8.4 years. Widening of the PDL involving at least one tooth was present in 38% of subjects, and 14.5% had at least one site in the mandible with an erosion. In analyses adjusting for age, disease duration, gender, smoking, and education, we found significant associations between the number of teeth with widening of the PDL and disease severity assessed by the physician global assessment (PGA) (RR=1.19, CI 1.02-1.39, p=0.028). Analyses replacing PGA with the skin score, disease subset or anti-topoisomerase I antibodies confirmed the relationship with indices of disease severity. There was no relationship between either the number of teeth with periodontal disease or the number of missing teeth, and the number of teeth with wide PDL. A smaller interdental distance (RR=0.89, CI 0.82-0.97, p=0.006), but not disease severity, facial skin score nor ischemia, was associated with a larger number of erosions.