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      Evolución del estudio de las manifestaciones bucomaxilofaciales del lupus eritematoso sistémico Translated title: Evolution of the study of bucomaxilofacial manifestations of Systemic Lupus Erythematosus

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          Abstract

          RESUMEN El lupus eritematoso sistémico provoca manifestaciones bucomaxilofaciales. Debido a su variabilidad, se torna complejo para el odontólogo evaluar a los pacientes que lo padecen, además de la escasa evidencia científica en cuanto al manejo en la cavidad bucal, que hacen difícil su identificación y diagnóstico. El propósito de la presente investigación es caracterizar la evolución histórica del estudio de las lesiones bucomaxilofaciales del lupus eritematoso sistémico, mediante una exhaustiva revisión bibliográfica y el empleo de descriptores en inglés y español. Esta enfermedad tiene consecuencias en la cavidad bucal, pero las lesiones pueden presentarse asintomáticas, por lo que el diagnóstico depende de identificar las lesiones. El estudio de las manifestaciones bucomaxilofaciales en esta enfermedad ha venido evolucionando lentamente con el transcurso del tiempo, pero aún no es suficiente, a pesar de los adelantos de la ciencia y la técnica.

          Translated abstract

          ABSTRACT Systemic Lupus Erythematosus in its development causes bucomaxilofacial manifestations. Given its variability, it becomes complex for the dentist when evaluating patients who suffer from it, due to the poor synthesis of evidence, based on its management in the oral cavity, from its identification and diagnosis. This led to the realization of this research, with the purpose of characterizing the historical evolution of the study process on bucomaxilofacial lesions, through an exhaustive literature review using different descriptors in English and Spanish. As a result, it was observed that this disease has consequences in the oral cavity, the lesions may appear asymptomatic and their presence is decisive for the diagnosis. Concluding that the study of bucomaxilofacial manifestations in Systemic Lupus Erythematosus has been evolving over time, but it is still not enough, and even more so with the advances in science and technology.

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          Rheumatoid arthritis affecting temporomandibular joint

          Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.
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            Late-onset systemic lupus erythematosus in Latin Americans: a distinct subgroup?

            Objective To examine the characteristics of patients who developed late onset systemic lupus erythematosus (SLE) in the GLADEL (Grupo Latino Americano de Estudio del Lupus) cohort of patients with SLE. Methods Patients with SLE of less than two years of disease duration, seen at 34 centers of nine Latin American countries, were included. Late-onset was defined as >50 years of age at time of first SLE-related symptom. Clinical and laboratory manifestations, activity index (SLEDAI), and damage index (SLICC/ACR- DI) were ascertained at time of entry and during the course (cumulative incidence). Features were compared between the two patient groups (<50 and ≥50) using descriptive statistics and hypothesis tests. Logistic regression was performed to examine the association of late-onset lupus, adjusting for other variables. Results Of the 1480 patients included, 102 patients (6.9 %) had late-onset SLE, 87% of which were female. Patients with late-onset SLE had a shorter follow-up (3.6 vs. 4.4 years, p < 0.002) and a longer time to diagnosis (10.1 vs. 5.8 months, p < 0.001) compared to the younger onset group. Malar rash, photosensitivity, and renal involvement were less prevalent while interstitial lung disease, pleural effusions, and sicca symptoms were more frequent in the older age group ( p > 0.05). In multivariable analysis, late onset was independently associated with higher odds of ocular (OR = 3.66, 95% CI = 2.15–6.23), pulmonary (OR = 2.04, 95% CI = 1.01–4.11), and cardiovascular (OR = 1.76, 95% CI = 1.04–2.98) involvement and lower odds of cutaneous involvement (OR = 0.41, 95% CI = 0.21–0.80), number of cumulative SLE criteria (OR = 0.79, 95% CI = 0.64–0.97), use of cyclophosphamide (OR = 0.47, 95% CI = 0.24–0.95), and anti-RNP antibodies (OR = 0.43, 95% CI = 0.20–0.91). A Cox regression model revealed a higher risk of dying in older onset than the younger-onset SLE (OR = 2.61, 95% CI = 1.2–5.6). Conclusion Late-onset SLE in Latin Americans had a distinct disease expression compared to the younger-onset group. The disease seems to be mild with lower cumulative SLE criteria, reduced renal/mucocutaneous involvements, and less use of cyclophosphamide. Nevertheless, these patients have a higher risk of death and of ocular, pulmonary, and cardiovascular involvements.
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              Incidencia de la alveolitis dental en pacientes con afecciones reumáticas

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                Author and article information

                Journal
                rcur
                Revista Cubana de Reumatología
                Rev Cuba Reumatol
                Editorial CIMEQ (La Habana, , Cuba )
                1817-5996
                December 2020
                : 22
                : 3
                : e794
                Affiliations
                [2] La Habana La Habana orgnameUniversidad de Ciencias Médicas de La Habana orgdiv1Hospital Universitario General Calixto García Cuba
                [1] Santiago de Cuba orgnameUniversidad de Ciencias Médicas de Santiago de Cuba orgdiv1Hospital Provincial Saturnino Lora Torres Cuba
                [3] Santiago de Cuba orgnameUniversidad de Ciencias Médicas de Santiago de Cuba orgdiv1Clínica Estomatológica del MININT Cuba
                Article
                S1817-59962020000300007 S1817-5996(20)02200300007
                e1a83c3e-7261-47ad-bfd1-5cb0ef9693a0

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 18 June 2020
                : 23 March 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 46, Pages: 0
                Product

                SciELO Cuba

                Categories
                Artículo de revisión

                lupus eritematoso sistémico,manifestaciones bucomaxilofaciales,enfermedades reumáticas,systemic lupus erythematosus,bucomaxilofacial manifestations,collagenopathy

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