ORAL MANIFESTATIONS IN A BONE MARROWTRANSPLANTED ADOLESCENT WITH SYSTEMIC SCLEROSIS: A CASE REPORT

Abstract

Objective: to report oral manifestations in a bone marrow-transplanted adolescent with systemic sclerosis. Case report: a 12-year-old female teenager was referred to a specialized dental care center for patients with special needs with a complaint of dental malocclusion. In the anamnesis, the caregiver reported diagnosis of systemic sclerosis at birth and hematopoietic stem cell transplantation to control the disease at 6 years of age. The patient chronically uses antihypertensive and anti-inflammatory drugs and reports xerostomia and dysphagia. Telangiectasias, facial atrophy, leukomelanoderma,  acrosclerosis, and sclerodactyly were observed in the extraoral physical examination. Microstomy, inadequate lip sealing, extrinsic pigmentation on teeth 12, 11, 21 and 22, marked horizontal overjet (11mm) and drug-induced gingival hyperplasia were also observed. Oral hygiene was satisfactory, and the patient had no carious lesions. The patient was referred for orthodontic treatment and is under follow-up with bimonthly preventive dental appointments. Conclusion: systemic sclerosis, even when controlled, can be associated with microstomy, inadequate lip sealing, extrinsic tooth staining, marked horizontal overjet, drug-induced gingival hyperplasia, and xerostomia. Therefore, it requires the prevention and control of oral diseases in order to improve dental management and monitor the patient’s oral condition.