PO:34:212 | Orofacial manifestations in systemic sclerosis: preliminary observational study and update of a single-center experience

Amelia Spinella¹, Marco De Pinto¹, Giacomo Setti², Martina Orlandi^1|3, Samuele Veronesi², Federica Lumetti¹, Alessia Laneri¹, Luca Keller Sarmiento¹, Giorgia Roveta¹, Gilda Sandri^1|3, Pierantonio Bellini², Ugo Consolo², Dilia Giuggioli^1|3 | ¹Università degli Studi di Milano, Dipartimento di Scienze Cliniche e di Comunità, Milano; ²ASST G. Pini-CTO, UOC di Clinica Reumatologica, Milano; ³UOC di Reumatologia Clinica Pediatrica, ASST Gaetano Pini-CTO, Milano, Italy

Background: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by endothelial dysfunction, tissue fibrosis, and immune dysregulation, leading to increased morbidity and mortality. Orofacial involvement—often underestimated—includes reduced mouth opening, periodontal alterations, hyposalivation, and masticatory difficulties, with a potential negative impact on quality of life. The aim of this study, conducted in collaboration between rheumatologists and dentists, was to investigate the correlations between systemic disease features and oral health parameters in a preliminary SSc cohort.

Materials and Methods: An observational study was conducted on 13 SSc patients (F/M 12/1) attending the Scleroderma Unit of the University Hospital of Modena. All patients fulfilled the 2013 ACR/EULAR classification criteria and were referred to the Dental Service for comprehensive evaluation. Demographic, clinical, serological, rheumatological, and dental parameters were assessed, including DMFT index, periodontal indices, mouth opening, salivary flow rate, and quality of life (SSc-HAQ). Statistical analyses included Spearman/Pearson correlations and non-parametric tests.

Results: The 13 enrolled patients presented a cutaneous subset distribution of dcSSc/lcSSc = 6/7, with a mean age of 56.5 ± 23.6 years. Older age was significantly associated with poorer oral health (r=0.79, p=0.002) and greater functional disability (r=0.83, p=0.0008). Patients with interstitial lung disease (ILD) exhibited a significant reduction in mouth opening (p=0.019). A strong positive correlation was also observed between plaque accumulation and disability index (r=0.72, p=0.006). Other non-significant trends suggested a possible association between limited cutaneous subset and reduced salivary flow.

Conclusions: In our experience, orofacial involvement in SSc—particularly in older patients and those with ILD—adversely affects oral function and quality of life. Regular oral health monitoring and early implementation of preventive and supportive strategies should be encouraged in the management of SSc patients. Further studies in larger cohorts are warranted to confirm these promising preliminary findings and to guide targeted interventions.