title: Occlusal and MRI characterizations in systemic sclerosis patients: A prospective study from Southern Italian cohort.
abstract: OBJECTIVE
  The aim of the present study was to assess the prevalence of temporomandibular joint (TMJ) symptoms, clinical and magnetic resonance imaging (MRI) findings in a cohort of Southern Italian patients with SSc.
  
  
  METHODS
  Twenty-seven patients with SSc (12 diffuse, 15 limited, mean age 53.9, SD±1.2) and 28 healthy subjects (mean age 54.8, SD±4.2) were enrolled in this observational cohort study. In all patients, clinical examination for assessing the presence of TMJ sounds, pain in the TMJ area, tenderness of masticatory muscles, limited mouth opening, pain assessment, MRI scan and Anamnestic and Dysfunctional Index were performed.
  
  
  RESULTS
  The test groups reported more clinical and MRI findings of TMJ symptoms and dysfunction than control group. The frequency distributions of symptoms were significantly different (P<0.05), in the test groups for TMJ sounds, pain during mandibular movement and difficulty in the maximum mouth opening. There was also a significant decrease (P<0.001), in the test groups, in the mean of leftward, rightward laterotrusion and protrusion. Correlation analysis allowed to affirm that maximum opening leftward laterotrusion, protrusion and click were significantly correlated to Modified Rodnan Skin Score. The mean duration of disease was significantly correlated, ever in total SSc group, only for the maximum mouth opening value.
  
  
  CONCLUSIONS
  This study demonstrates that TMJ involvement is common in SSc patients and is correlated with a length and involvement of disease and supports the notion that TMJ examination should be encouraged in the rheumatology setting and clinicians should provide a right pain management and patient support.
authors.affiliation: Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, University of Messina, AOU Policlinico "G. Martino", via C. Valeria, 98125 Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Matarese
authors.affiliation: Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, University of Messina, AOU Policlinico "G. Martino", via C. Valeria, 98125 Messina, Italy; Department of Neurosciences, Reproductive and Odontostomatological Sciences, school of medicine, university of Naples "Federico II", 80100 Naples, Italy. Electronic address: gisola@unime.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Isola
authors.affiliation: Department of economical, business and environmental sciences and quantitative methods, university of Messina, 98125 Messina, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Alibrandi
authors.affiliation: Unit of internal medicine, department of clinical and experimental medicine, university of Messina, 98125 Messina, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lo Gullo
authors.affiliation: Unit of internal medicine, department of clinical and experimental medicine, university of Messina, 98125 Messina, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Bagnato
authors.affiliation: Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, University of Messina, AOU Policlinico "G. Martino", via C. Valeria, 98125 Messina, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cordasco
authors.affiliation: Department of orthodontics, second university of Naples, 80100 Naples, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Perillo
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012595:Scleroderma, Systemic / Q000209:etiology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000150:complications / Q000175:diagnosis*
keywords: Pain; Scleroderma; Stomatognathic apparatus; Systemic sclerosis; Temporomandibular diseases; Temporomandibular joint