Relationship between Periodontitis and Psychosocial Impact in Patients with Systemic Sclerosis: A Clinical Study

Alessandro Polizzi, Simona Santonocito, Manuel Vaccaro, Grazia Fichera, Salvatore Torrisi, Vincenzo Ronsivalle, Giuseppe Palazzo, Federica Sicari, Francesco Indelicato


Background: Systemic Sclerosis (SSc) is a multi-system disorder that can have significant adverse effects upon the oral health. The aim of this study was to analyze the associations between SSc, periodontal disease (PD) and tooth loss and oral health-related quality of life (OHRQoL).

Methods: For the study were enrolled 70 patients affected by SSc and 75 non-diseased controls matched for age and gender. SSc was characterized in subtypes and with the mean duration of disease and the Modified Rodnan Skin Score [mRSS]. Patients were surveyed and examined through the evaluation of the periodontal parameters and the number of teeth and OHRQoL scores.

Results: A logistic regression analysis showed that patients with SSc presented a higher number of missing teeth (p=0.001) and a 6.89-fold (95% CI 2.04 to 18.36) increased odds of CAL compared to the control group. Moreover, the less values of PPD was correlated with mRSS in the total SSc group and with the mean duration of disease in patients with limited SSc, even after adjusting this correlation with the presence of the major organ involvement.

The OHIP sub-scale psychosocial impact differed significantly between groups (p= 0.002). The OHIP sum score was also significantly different between groups (p< 0.001).

Conclusions : This study showed that patients with SSc presented an increased odds of PD and tooth loss compared to non-diseased controls. In SSc patients, the magnitude of PD was strongly associated with the mRSS and with the mean duration of the disease.


Systemic Sclerosis; Oral Health; Periodontal disease; Psychological well-being.

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