AB1120 Rehabilitation of Temporomandibular Joint (TMJ) in Patients with Systemic Sclerosis (SSC). A Comparison between Two Protocols: Preliminary Results

Background In SSc patients, microstomia is frequent and impairs mouth function. It may be due to fibrosis of skin face and to changes in TMJ, scarcely evaluated and treated with rehabilitation in SSc. Objectives To evaluate, in SSc patients (pts) with microstomia due to TMJ dysfunction, the efficacy of 2 rehabilitation protocol. Methods We enrolled 26 SSc pts (22 women, 4 men; age and disease duration: 59.08±10.31 and 13.65±5.71 years) with microstomia and TMJ dysfunction. Group 1 (13 pts) was treated by Protocol 1 (P1) (home exercises for mimic, masticatory and neck muscles; 20 minutes/day, 3 days/week) and group 2 (13 pts) was treated by Protocol 2 (exercises plus face and neck,connective tissue massage, Kabat technique for mimic muscles, manual techniques -intra- and extra-oral manipulation of TMJ, stretching and mobilization of cranio-cervical muscles-; 1 hour/week). Pts were evaluated at T0, at T1 (end of treatment; week 12) and at T2 (at 8 weeks of follow-up) by: Helkimo Index (Anamnestic -A-dysfunction -D- and occlusal-O- index), for TMJ dysfunction; mobility of cervical rachis (cm) and mouth (ROM) (mm); SSc face involvement (facial skin score; Mouth Handicap in SSc scale–MHISS-). Results At T1, both protocols improved Helkimo A index and Helkimo O Score, while only protocol 2 improved Helkimo D (p