title: Relationship Between Disease Characteristics and Oral Radiologic Findings in Systemic Sclerosis: Results From a Canadian Oral Health Study.
abstract: Systemic sclerosis (SSc; scleroderma) is associated with a wide periodontal ligament (PDL) and mandibular erosions. We investigated the clinical correlates of SSc with these radiologic abnormalities.
  
  
  
  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.
  
  
  
  The study included 159 subjects; 90.6% were women, the mean ± SD age was 56 ± 10 years, diffuse disease was present in 28.3%, and mean ± SD disease duration was 13.7 ± 8.4 years. Widening of the PDL involving at least 1 tooth was present in 38% of subjects, and 14.5% had at least 1 site in the mandible with an erosion. In analyses adjusting for age, disease duration, sex, 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) (relative risk [RR] 1.19, 95% confidence interval [95% CI] 1.02-1.39, P = 0.028). Analyses replacing the 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, 95% CI 0.82-0.97, P = 0.006), but not disease severity, facial skin score, or ischemia was associated with a larger number of erosions.
  
  
  
  In SSc, a wide PDL may reflect generalized overproduction of collagen, and mandibular erosions are related to local factors in the oral cavity.
authors.affiliation: Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
authors.affiliation: Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Hudson
authors.affiliation: Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Dagenais
authors.affiliation: University of British Columbia, Vancouver, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Macdonald
authors.affiliation: Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Gyger
authors.affiliation: University of Western Ontario, London, Ontario, Canada.
authors.forename: Tarek
authors.initials: T
authors.lastname: El Sayegh
authors.affiliation: University of Western Ontario, London, Ontario, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: Pope
authors.affiliation: Clinique Dentaire Ayotte et Associatees, Sherbrooke, Quebec, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Fontaine
authors.affiliation: University of Sherbrooke, Sherbrooke, Quebec, Canada.
authors.forename: Ariel
authors.initials: A
authors.lastname: Masetto
authors.affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Debora
authors.initials: D
authors.lastname: Matthews
authors.affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Sutton
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Norman
authors.initials: N
authors.lastname: Thie
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Niall
authors.initials: N
authors.lastname: Jones
authors.affiliation: University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Copete
authors.affiliation: University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Dean
authors.initials: D
authors.lastname: Kolbinson
authors.forename: Janet
authors.initials: J
authors.lastname: Markland
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Getulio
authors.initials: G
authors.lastname: Nogueira-Filho
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Robinson
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Marvin
authors.initials: M
authors.lastname: Fritzler
authors.affiliation: Mianbo Wang, MD, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Mianbo
authors.initials: M
authors.lastname: Wang
authors.affiliation: Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Mervyn
authors.initials: M
authors.lastname: Gornitsky
mesh_terms: D000368:Aged; D002170:Canada; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology; D008336:Mandibular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D010510:Periodontal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D010513:Periodontal Ligament / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D012720:Severity of Illness Index; D016388:Tooth Loss / Q000000981:diagnostic imaging / Q000209:etiology