title: Surgical orodental implications in ankylosing spondylitis.
abstract: Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS) is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any subluxation of fracture of cervical vertebrae. Neck was supported to insure neck stability during surgical forces. In addition, considering consumption of immunosuppressive medications including corticosteroids, procedure was performed with a great care, with attention to higher possibility of infection and fracture. Access to the surgical site was not desirable, though surgery accomplished without any significant event and the patient discharged with routine analgesic and antibiotics recommendation. Sometimes, impaired access to the oral cavity in patients with AS leads to receive suboptimal or minimal orodental care. Long list of dental implications in these patients may be simplified by considering of careful neck and jaw support, applying at least possible forces and great attention to the infection control rules. It is wised to be performed under patient and skilled hands.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Babol University of Medical Sciences, Babol, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mehdizadeh
authors.forename: Bejeh Mir A
authors.initials: BM
authors.lastname: Poorsattar
keywords: Ankylosing spondylitis; immunosuppressant; oral surgery; temporomandibular joint
references.citation: J Clin Microbiol. 1999 Sep;37(9):2808-12
references.pmid: 10449457
references.citation: Rheumatol Int. 2003 Mar;23(2):61-6
references.pmid: 12634937
references.citation: Br J Oral Maxillofac Surg. 2007 Sep;45(6):507-10
references.pmid: 16875761
references.citation: South Med J. 2007 Apr;100(4):366-70
references.pmid: 17458395
references.citation: Spine J. 2008 Jul-Aug;8(4):678-82
references.pmid: 17697804
references.citation: Cranio. 2003 Jul;21(3):202-8
references.pmid: 12889677
references.citation: Oral Surg Oral Med Oral Pathol. 1994 Jun;77(6):572-8
references.pmid: 8065718
references.citation: Br J Oral Maxillofac Surg. 2009 Mar;47(2):159-61
references.pmid: 19019507
references.citation: Ann N Y Acad Sci. 2000;917:825-34
references.pmid: 11268412
references.citation: JAMA. 1977 Jun 13;237(24):2613-4
references.pmid: 140252
references.citation: Scand J Rheumatol. 1997;26(2):133-4
references.pmid: 9137330
references.citation: Arthritis Rheum. 1958 Dec;1(6):553-63
references.pmid: 13607268
references.citation: Clin Rheumatol. 2008 Apr;27(4):457-62
references.pmid: 17899306
references.citation: J Manipulative Physiol Ther. 1993 May;16(4):256-65
references.pmid: 8340721
references.citation: Cranio. 2007 Oct;25(4):237-49
references.pmid: 17983123
references.citation: J Craniomandib Disord. 1990 Winter;4(1):52-7
references.pmid: 2098388
references.citation: Eur J Oral Sci. 1995 Feb;103(1):2-7
references.pmid: 7600245
references.citation: J Manipulative Physiol Ther. 1994 Nov-Dec;17(9):614-9
references.pmid: 7884333
references.citation: Clin Exp Rheumatol. 2008 May-Jun;26(3):498-504
references.pmid: 18578977
references.citation: Clin Rheumatol. 1996 Jan;15 Suppl 1:62-66
references.pmid: 8835506
references.citation: Ann Rheum Dis. 1988 Jan;47(1):84-5
references.pmid: 3278697
references.citation: Scand J Dent Res. 1982 Oct;90(5):373-81
references.pmid: 6960467
references.citation: Baillieres Clin Rheumatol. 1989 Aug;3(2):321-38
references.pmid: 2670258
references.citation: Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S16-22
references.pmid: 12463441
references.citation: World J Orthod. 2009 Winter;10(4):371-7
references.pmid: 20072755
references.citation: Stomatologiia (Mosk). 1997;76(1):18-21
references.pmid: 9148508
references.citation: Best Pract Res Clin Rheumatol. 2006 Jun;20(3):601-9
references.pmid: 16777585