Scleromyxedema problem in odontological practice

Abstract

Scleromyxedema is a skin disorder, which is considered very rare. Its symptoms are mucin accumulation in the patients’ skin, which is also called mucinosis. It causes papular and sclerodermoid bumps. Also, people affected by this disease have increased production of fibroblasts in the absence of a thyroid disorder. Another symptom includes monoclonal gammopathy, which is shown as abnormal protein existence in the person’s blood. This disease has no standard treatment. All patients should have their life quality improved by any means possible. These ses are extremely challenging for most of the treatments, that are being made by a dentist, because the patient is unable to open his mouth wide enough, so that standard dental manipulations can be made. A 60-year-old patient was presented with Scleromyxedema to our clinic. He was unable to open his mouth by more than 1,7 centimeters, which is considered a very narrow mouth opening. Patients face muscles were rigid, especially – musculus orbicularis oris and musculus masseter. Any attempts to open the mouth by more than 1,7 centimeters resulted with ruptures in patients mouth corners. Intra-oral Examination revealed 2 teeth left in the lower jaw, and no teeth in the upper jaw. Patient was in need of masticatory function rehabilitation, phonetics and aesthetics improvement. Such case requires special procedures and specific adaptation, compared to a standard edentulous patients’ treatment. In this case report, we review all the intra oral procedures, which should be modified accordingly to this rare case. Clinicians should be informed of such rare diseases and should be able to diagnose and treat them accordingly.