What are examples of multisystem vaculitic inflammatory diseases?
- systemic lupus erythematosis
- systemic sclerosis
- sjogrens syndrome
- undifferentiated connective tissue disease
What are examples of Vasculitic Connective Tissue diseases?
- giant cell (temporal) arteritis
- polysrteritis nodosa
- small vessel disease
What are generally used to manage connective tissue disease?
Dependant on disease activity:
- Analgesic NSAIDs
- immune modulators
- systemic steroids
What are first line immune modulating drugs used to treat connective tissue diseases?
- hydroxychloroquine
- methitrexate
What are second line/backup immune modulating drugs sometimes used to treat connective tissue diseases (given that first line drugs don’t work)?
- azathioprine
- mycophenolate
- cytokine inhibitors and lymphocyte depleting drugs
Give an examples of a systemic steroid drug use to treat connective tissue disease?
Prednisolone
Why are immune connective tissue diseases known as spectrum disorders?
Disorders tend to overlap and a person may show signs/symptoms of multiple diseases
- lupus is the worst combining ALL connective tissue diseases
What connective tissue diseases all combine to form Lupus?
- scleroderma
- rheumatoid arthritis
- sjogrens syndrome
- raynauds phenomenon
- mixed connective tissue disease
What antibodies are commonly found in all connective tissue diseases?
- ANA (anti-nuclear antibody)
- dsDNA (anti-double-strand DNA)
- Ro (anti-ro antibody)
- La (anti-la antibody)
What antibodies are commonly found in scleroderma disease?
- Anti-Centromere antibody
- Anti-Scl-70 antibody
What is Discoid Lupus?
Tissue changes without blood antibodies
- seen in the skin and mouth
- looks similar to lichen planus
What are general whole body features commonly seen in patients with Systemic Lupus Erythematosis?
- butterfly rash
- heart problems
- arthritis
- Raynaud’s
- lupus nephritis
What are some dental aspects of Systemic Lupus Erythematosis?
- chronic anaemia = oral ulceration & GA risk
- bleeding tendency = thrombocytopenia
- renal disease = impaired drug metabolism
- drug reactions
- steroid & immunosuppresive therapy
- lichenoid oral reactions
- oral pigmentation = hydroxychloroquine use
What are Antiphospholipid Antibody Syndrome patients suffering with?
A form of Lupus
- marker found in their body that will anticoagulate blood in a test tube but NOT in patient
- aPL antibody
- aCL antibody
What is antiphospholipic antibody syndrome characterised by? What do these patients require?
recurrent thrombosis
- DVT with pulmonary embolism
- MUST BE anticoagulated and you CANNOT stop anticoagulant
How can Sjogren’s Syndrome be diagnosed?
No one test to prove disease. Use a combination of:
- dry eyes/mouth
- autoantibody findings (ANA and Ro)
- imaging findings (disease in salivary gland)
- histopathology findings
What are some oral/dental implications of Sjogrens Syndrome?
- reduced salivary flow
- oral infection
- caries risk
- functinal loss (difficulty talking/eating etc)
- poor denture retention
- sialosis (swelling of salivary glands)
- salivary lymphoma
What is systemic sclerosis?
- excessive collagen deposition
- connective tissue fibrosis
- loss of elastic tissue
What are some dental aspects of systemic sclerosis?
- limited mouth opening & poor oral access
- dysphagia & reflux (dental erosion)
- widening of PDL space
What is vasculitis?
inflammation of blood vessel walls
What is polymyalgia rheumatica?
Disease of the elderly causing pain & morning stiffness of muscles
- responds well to steroids
How does Wegener’s Granulomatosis present in the oral cavity?
Gingiva have a strawberry like appearance
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BONE DISEASES32
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GOUT & OSTEOARTHRITIS21
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Rhematoid Arthritis29
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Stroke31
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Epilepsy30
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Pregnancy & Perinatal health21
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Degenerative Brain Disease26
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Milestones, Screening & Vaccinations22
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Psychiatry19
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Dermatology51
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Cancer & Cancer Treatment14
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Dental Treatment for the Cancer Patient14
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Connective Tissue Diseases22
