{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:56:41Z","timestamp":1781636201444,"version":"3.54.5"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Adv Rheumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic sclerosis (SSc) is a chronic and heterogeneous disorder characterized by vascular, inflammatory, and fibrotic changes in the skin and internal organs. As epidemiological studies on SSc in Brazil are few, most reports are from international literature. This study aimed to determine the incidence, prevalence, clinical and laboratory characteristics, and therapeutic management of patients diagnosed with SSc in Cascavel, a southern Brazilian city. Methods: Cross-sectional study that collected data from all rheumatology services in the city (six private rheumatology clinics, a regional specialty center, a municipal specialty center, and an outpatient clinic at a university hospital) in 2020. After the epidemiological survey, eligible patients were invited to undergo investigation for possible orofacial manifestations. Results: We identified 57 patients who were treated for SSc in clinics, 30 of whom lived in Cascavel, Brazil. The estimated prevalence of SSc was 9\u2009\u00b1\u20090.03 cases\/100,000 population, and the incidence in 2020 was 1.2\u2009\u00b1\u20090.004 cases\/100,000 population. Most patients were female, and the mean age at diagnosis was 42.5\u2009\u00b1\u200917.22 years. The most frequently reported clinical feature is Raynaud\u2019s phenomenon, followed by skin thickening. Limited SSc was the SSc syndrome most frequently identified by physicians, and the antinuclear antibody test was positive in 86.66% of the patients. Six patients participated in the orofacial alteration investigation. Half of the patients had very low hyposalivation, and all had telangiectasias and periodontal disease. Conclusions: Clinical and epidemiological data from Cascavel, Brazil corroborate the findings of previous studies. Orofacial compromise was common in patients with SSc. Increased awareness among healthcare teams managing these patients is necessary to evaluate and manage orofacial problems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42358-026-00526-2","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:35:43Z","timestamp":1771670143000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, prevalence and clinical features of systemic sclerosis patients from a southern Brazilian city"],"prefix":"10.1186","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-4139","authenticated-orcid":false,"given":"Alana Rubia","family":"Balbinot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7900-3874","authenticated-orcid":false,"given":"Let\u00edcia de Abreu","family":"Wiedmer de Siqueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-1049","authenticated-orcid":false,"given":"Poliana Vieira","family":"da Silva Menolli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2728-8318","authenticated-orcid":false,"given":"Rafael Andrade","family":"Menolli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6903-6712","authenticated-orcid":false,"given":"Ana Paula","family":"Adame","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"issue":"6","key":"526_CR1","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1590\/S0365-05962011000600003","volume":"86","author":"TL Skare","year":"2011","unstructured":"Skare TL, Fonseca AE, Luciano AC, Azevedo PM. Autoantibodies in scleroderma and their association with the clinical profile of the disease. A study of 66 patients from Southern Brazil. Bras Dermatol. 2011;86(6):1075\u201381.","journal-title":"Bras Dermatol"},{"issue":"2","key":"526_CR2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4103\/0975-962X.184645","volume":"7","author":"R Srivastava","year":"2016","unstructured":"Srivastava R, Jyoti B, Bihari M, Pradhan S. Progressive systemic sclerosis with intraoral manifestations: A case report and review. Indian J Dent. 2016;7(2):99.","journal-title":"Indian J Dent"},{"issue":"3","key":"526_CR3","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1186\/ar402","volume":"4","author":"AL Herrick","year":"2002","unstructured":"Herrick AL, Worthington J. Genetic epidemiology: systemic sclerosis. Arthritis Res. 2002;4(3):165\u20138.","journal-title":"Arthritis Res"},{"issue":"2","key":"526_CR4","first-page":"131","volume":"46","author":"AL Herrick","year":"2018","unstructured":"Herrick AL. Systemic sclerosis: clinical features and management. Med (United Kingdom). 2018;46(2):131\u20139.","journal-title":"Med (United Kingdom)"},{"issue":"11","key":"526_CR5","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1002\/art.38098","volume":"65","author":"F Van Den Hoogen","year":"2013","unstructured":"Van Den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. 2013 classification criteria for systemic sclerosis: an American college of Rheumatology\/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2013;65(11):2737\u201347.","journal-title":"Arthritis Rheum"},{"issue":"2 Suppl 65","key":"526_CR6","first-page":"S10","volume":"29","author":"A Lo Monaco","year":"2011","unstructured":"Lo Monaco A, Bruschi M, La Corte R, Volpinari S, Trotta F. Epidemiology of systemic sclerosis in a district of Northern Italy. Clin Exp Rheumatol. 2011;29(2 Suppl 65):S10\u20134.","journal-title":"Clin Exp Rheumatol"},{"key":"526_CR7","doi-asserted-by":"crossref","unstructured":"Alamanos Y, Tsifetaki N, Voulgari PV, Venetsanopoulou AI, Siozos C, Drosos AA. Epidemiology of primary Sj\u00f6gren\u2019s syndrome in north-west Greece, 1982\u20132003. Rheumatology (Oxford). 2006 Feb;45(2):187\u201391.","DOI":"10.1093\/rheumatology\/kei107"},{"key":"526_CR8","doi-asserted-by":"crossref","unstructured":"Horimoto AMC, Matos ENN, Costa MR da, Takahashi F, Rezende MC, Kanomata LB, et al. Incid\u00eancia e preval\u00eancia de esclerose sist\u00eamica em Campo Grande, Estado de Mato Grosso do Sul, Brasil. Rev Bras Reumatol. 2016;57(2):107\u201314.","DOI":"10.1016\/j.rbr.2016.05.008"},{"issue":"1","key":"526_CR9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1590\/S0482-50042004000100007","volume":"44","author":"A Beatriz","year":"2004","unstructured":"Beatriz A, Azevedo C, De, Sampaio-barros PD, Moraes R, Moreira C. Avalia\u00e7\u00e3o Da Preval\u00eancia de Hipertens\u00e3o pulmonar. Rev Bras Reumatol. 2004;44(1):31\u20139.","journal-title":"Rev Bras Reumatol"},{"issue":"8","key":"526_CR10","first-page":"1520","volume":"52","author":"RG Marangoni","year":"2013","unstructured":"Marangoni RG, Rocha LF, Del Rio APT, Yoshinari NH, Marques-Neto JF, Sampaio-Barros PD. Systemic sclerosis sine scleroderma: distinct features in a large Brazilian cohort. Rheumatol (United Kingdom). 2013;52(8):1520\u20134.","journal-title":"Rheumatol (United Kingdom)"},{"issue":"6","key":"526_CR11","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1038\/sj.bdj.2016.678","volume":"221","author":"BJ Veale","year":"2016","unstructured":"Veale BJ, Jablonski RY, Frech TM, Pauling JD. Orofacial manifestations of systemic sclerosis. Br Dent J 23 De Setembro De. 2016;221(6):305\u201310.","journal-title":"Br Dent J 23 De Setembro De"},{"issue":"3","key":"526_CR12","doi-asserted-by":"publisher","first-page":"153","DOI":"10.5455\/medarh.2015.69.153-156","volume":"69","author":"I Bajraktari","year":"2015","unstructured":"Bajraktari I, Kryeziu A, Sherifi F, Bajraktari H, Lahu A, Bajraktari G. Oral manifestations of systemic sclerosis and correlation with anti-Topoisomerase I antibodies (SCL-70). Med Archives. 2015;69(3):153.","journal-title":"Med Archives"},{"issue":"2","key":"526_CR13","doi-asserted-by":"publisher","first-page":"271","DOI":"10.4103\/0972-124X.99275","volume":"16","author":"R Jagadish","year":"2012","unstructured":"Jagadish R, Jagadish P, Mehta D. Oral and periodontal manifestations associated with systemic sclerosis: A case series and review. J Indian Soc Periodontol. 2012;16(2):271.","journal-title":"J Indian Soc Periodontol"},{"issue":"2","key":"526_CR14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/0030-4220(88)90161-2","volume":"65","author":"RE Wood","year":"1988","unstructured":"Wood RE, Lee P. Analysis of the oral manifestations of systemic sclerosis (scleroderma). Oral Surg Oral Med Oral Pathol Fevereiro De. 1988;65(2):172\u20138.","journal-title":"Oral Surg Oral Med Oral Pathol Fevereiro De"},{"key":"526_CR15","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE). Estimativas da popula\u00e7\u00e3o residente no Brasil e unidades da Federa\u00e7\u00e3o com data de refer\u00eancia em 1\u00ba de julho de 2020. IBGE. 2020;(3):119."},{"issue":"9596","key":"526_CR16","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet Outubro De. 2007;370(9596):1453\u20137.","journal-title":"Lancet Outubro De"},{"issue":"7","key":"526_CR17","first-page":"1573","volume":"28","author":"EC LeRoy","year":"2001","unstructured":"LeRoy EC, Medsger TA Jr. Criteria for the classification of early systemic sclerosis. J Rheumatol [Internet] Julho De. 2001;28(7):1573\u20136. Dispon\u00edvel em:. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11469464.","journal-title":"J Rheumatol [Internet] Julho De"},{"issue":"1","key":"526_CR18","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1159\/000260369","volume":"12","author":"Y Ericsson","year":"1978","unstructured":"Ericsson Y, Hardwick L. Individual Diagnosis, prognosis and counselling for caries prevention. Caries Res. 1978;12(1):94\u2013102.","journal-title":"Caries Res"},{"issue":"1","key":"526_CR19","first-page":"162","volume":"28","author":"SEZ Baldrighi","year":"2016","unstructured":"Baldrighi SEZ, de Almeida M, Alves LF, Silva CS, da AKA, Barros Filho L, Macieira JC, et al. Maximum amplitude of mouth opening in systemic sclerosis. Disturbios Da Comunica\u00e7\u00e3o. 2016;28(1):162\u20139.","journal-title":"Disturbios Da Comunica\u00e7\u00e3o"},{"issue":"12","key":"526_CR20","first-page":"27","volume":"2","author":"CL Foga\u00e7a","year":"1998","unstructured":"Foga\u00e7a CL. Maximum mouth opening: clinical study - direct method. Jornal Brasileiro De Odontologia Cl\u00ednica. 1998;2(12):27\u201330.","journal-title":"Jornal Brasileiro De Odontologia Cl\u00ednica"},{"issue":"4","key":"526_CR21","first-page":"229","volume":"25","author":"J Ainamo","year":"1975","unstructured":"Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J Dezembro De. 1975;25(4):229\u201335.","journal-title":"Int Dent J Dezembro De"},{"key":"526_CR22","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/jcpe.12852","volume":"45","author":"JG Caton","year":"2018","unstructured":"Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol Junho De. 2018;45:S1\u20138.","journal-title":"J Clin Periodontol Junho De"},{"key":"526_CR23","doi-asserted-by":"publisher","first-page":"257","DOI":"10.2147\/CLEP.S191418","volume":"11","author":"A Bergamasco","year":"2019","unstructured":"Bergamasco A, Hartmann N, Wallace L, Verpillat P. Epidemiology of systemic sclerosis and systemic sclerosis-associated interstitial lung disease. Clin Epidemiol. 2019;11:257\u201373.","journal-title":"Clin Epidemiol"},{"issue":"8","key":"526_CR24","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/rheumatology\/ken179","volume":"47","author":"N Hunzelmann","year":"2008","unstructured":"Hunzelmann N, Genth E, Krieg T, Lehmacher W, Melchers I, Meurer M, et al. The registry of the German network for systemic scleroderma: frequency of disease subsets and patterns of organ involvement. Rheumatology. 2008;47(8):1185\u201392.","journal-title":"Rheumatology"},{"issue":"4","key":"526_CR25","first-page":"314","volume":"51","author":"C de Souza M\u00fcller","year":"2011","unstructured":"de Souza M\u00fcller C, dos Santos Paiva E, Azevedo VF, Radominski SC, Filho JHCL. Autoantibody profile and clinical correlation in a group of patients with systemic sclerosis in Southern Brazil. Rev Bras Reumatol. 2011;51(4):314\u201324.","journal-title":"Rev Bras Reumatol"},{"issue":"2","key":"526_CR26","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1097\/RHU.0b013e31820e7e8d","volume":"17","author":"JE Rosa","year":"2011","unstructured":"Rosa JE, Soriano ER, Narvaez-Ponce L, Del Cid CC, Imamura PM, Catoggio LJ. Incidence and prevalence of systemic sclerosis in a healthcare plan in Buenos Aires. J Clin Rheumatol. 2011;17(2):59\u201363.","journal-title":"J Clin Rheumatol"},{"issue":"10","key":"526_CR27","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.3899\/jrheum.111582","volume":"39","author":"PD Sampaio-Barros","year":"2012","unstructured":"Sampaio-Barros PD, Bortoluzzo AB, Marangoni RG, Rocha LF, Del Rio APT, Samara AM, et al. Survival, causes of death, and prognostic factors in systemic sclerosis: analysis of 947 Brazilian patients. J Rheumatol. 2012;39(10):1971\u20138.","journal-title":"J Rheumatol"},{"issue":"2","key":"526_CR28","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/S0889-857X(03)00022-X","volume":"29","author":"MD Mayes","year":"2003","unstructured":"Mayes MD. Scleroderma epidemiology. Rheumatic Disease Clin. 2003;29(2):239\u201354.","journal-title":"Rheumatic Disease Clin"},{"issue":"5","key":"526_CR29","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1093\/rheumatology\/keh124","volume":"43","author":"RJ Allcock","year":"2004","unstructured":"Allcock RJ, Forrest I, Corris PA, Crook PR, Griffiths ID. A study of the prevalence of systemic sclerosis in Northeast England. Rheumatology. 2004;43(5):596\u2013602.","journal-title":"Rheumatology"},{"issue":"5","key":"526_CR30","doi-asserted-by":"publisher","first-page":"A311","DOI":"10.1016\/j.autrev.2009.11.003","volume":"9","author":"B Ranque","year":"2010","unstructured":"Ranque B, Mouthon L. Geoepidemiology of systemic sclerosis. Autoimmun Rev. 2010;9(5):A311\u20138.","journal-title":"Autoimmun Rev"},{"issue":"10","key":"526_CR31","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1136\/annrheumdis-2013-203618","volume":"73","author":"K Andr\u00e9asson","year":"2014","unstructured":"Andr\u00e9asson K, Saxne T, Bergknut C, Hesselstrand R, Englund M. Prevalence and incidence of systemic sclerosis in Southern sweden: Population-based data with case ascertainment using the 1980 ARA criteria and the proposed ACR-EULAR classification criteria. Ann Rheum Dis. 2014;73(10):1788\u201392.","journal-title":"Ann Rheum Dis"},{"issue":"5","key":"526_CR32","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/S2255-5021(13)70111-1","volume":"53","author":"CC Leite","year":"2013","unstructured":"Leite CC, Maia \u00c2C. Symptoms of disease and psychological adaptation in Brazilian scleroderma patients. Revista Brasileira De Reumatologia (English Edition). 2013;53(5):405\u201311.","journal-title":"Revista Brasileira De Reumatologia (English Edition)"},{"issue":"4","key":"526_CR33","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1093\/rheumatology\/keq310","volume":"50","author":"M Bassel","year":"2011","unstructured":"Bassel M, Hudson M, Taillefer SS, Schieir O, Baron M, Thombs BD. Frequency and impact of symptoms experienced by patients with systemic sclerosis: results from a Canadian National survey. Rheumatology. 2011;50(4):762\u20137.","journal-title":"Rheumatology"},{"key":"526_CR34","doi-asserted-by":"crossref","unstructured":"Mierau R, Moinzadeh P, Riemekasten G, Melchers I, Meurer M, Reichenberger F et al. Frequency of disease-associated and other nuclear autoantibodies in patients of the German network for systemic scleroderma: correlation with characteristic clinical features. Arthritis Res Ther. 2011;13(5).","DOI":"10.1186\/ar3495"},{"issue":"8","key":"526_CR35","doi-asserted-by":"publisher","first-page":"2471","DOI":"10.1007\/s00296-011-1988-6","volume":"32","author":"T Schmeiser","year":"2012","unstructured":"Schmeiser T, Saar P, Jin D, Noethe M, M\u00fcller A, Soydan N, et al. Profile of Gastrointestinal involvement in patients with systemic sclerosis. Rheumatol Int 19 De Agosto De. 2012;32(8):2471\u20138.","journal-title":"Rheumatol Int 19 De Agosto De"},{"key":"526_CR36","doi-asserted-by":"crossref","unstructured":"Thoua NM, Bunce C, Brough G, Forbes A, Emmanuel AV, Denton CP. Assessment of Gastrointestinal symptoms in patients with systemic sclerosis in a UK tertiary referral centre. Rheumatol 1o De Setembro De. 2010;49(9):1770\u20135.","DOI":"10.1093\/rheumatology\/keq147"},{"issue":"6","key":"526_CR37","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1007\/BF00371817","volume":"283","author":"T Tamaki","year":"1991","unstructured":"Tamaki T, Mori S, Takehara K. Epidemiological study of patients with systemic sclerosis in Tokyo. Arch Dermatol Res. 1991;283(6):366\u201371.","journal-title":"Arch Dermatol Res"},{"issue":"1","key":"526_CR38","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s12016-018-8718-8","volume":"58","author":"A Stochmal","year":"2020","unstructured":"Stochmal A, Czuwara J, Trojanowska M, Rudnicka L. Antinuclear antibodies in systemic sclerosis: an update. Clin Rev Allergy Immunol. 2020;58(1):40\u201351.","journal-title":"Clin Rev Allergy Immunol"},{"issue":"1","key":"526_CR39","first-page":"43","volume":"48","author":"RM Bernstein","year":"1982","unstructured":"Bernstein RM, Steigerwald JC, Tan EM. Association of antinuclear and antinucleolar antibodies in progressive systemic sclerosis. Clin Exp Immunol. 1982;48(1):43\u201351.","journal-title":"Clin Exp Immunol"},{"issue":"4","key":"526_CR40","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1093\/rheumatology\/keg170","volume":"42","author":"R Hesselstrand","year":"2003","unstructured":"Hesselstrand R, Scheja A, Shen GQ, Wiik A, \u00c5kesson A. The association of antinuclear antibodies with organ involvement and survival in systemic sclerosis. Rheumatology. 2003;42(4):534\u201340.","journal-title":"Rheumatology"},{"issue":"3","key":"526_CR41","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.jaut.2003.12.004","volume":"22","author":"C Dahle","year":"2004","unstructured":"Dahle C, Skogh T, \u00c5berg AK, Jalal A, Olc\u00e9n P. Methods of choice for diagnostic antinuclear antibody (ANA) screening: benefit of adding antigen-specific assays to Immunofluorescence microscopy. J Autoimmun. 2004;22(3):241\u20138.","journal-title":"J Autoimmun"},{"issue":"4","key":"526_CR42","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1111\/j.1365-2230.1994.tb01199.x","volume":"19","author":"HL CHAN","year":"1994","unstructured":"Chan HL, Lee YS, Hong HS, Kuo TT. Anticentromere antibodies (ACA): clinical distribution and disease specificity. Clin Exp Dermatol Julho De. 1994;19(4):298\u2013302.","journal-title":"Clin Exp Dermatol Julho De"},{"key":"526_CR43","doi-asserted-by":"crossref","unstructured":"Pappas-Taffer L. Systemic sclerosis. Inpatient Dermatology. 2018. 367\u201370 p.","DOI":"10.1007\/978-3-319-18449-4_74"},{"issue":"3","key":"526_CR44","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1590\/S0482-50042004000300007","volume":"44","author":"LEC Andrade","year":"2004","unstructured":"Andrade LEC, Leser PG. Auto-anticorpos Na esclerose Sist\u00eamica (ES). Rev Bras Reumatol Junho De. 2004;44(3):215\u201323.","journal-title":"Rev Bras Reumatol Junho De"},{"issue":"2","key":"526_CR45","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/ar628","volume":"5","author":"KT Ho","year":"2003","unstructured":"Ho KT, Reveille JD. The clinical relevance of autoantibodies in scleroderma. Arthritis Res Ther. 2003;5(2):80\u201393.","journal-title":"Arthritis Res Ther"},{"issue":"3","key":"526_CR46","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.stomax.2010.04.001","volume":"111","author":"C Vincent","year":"2010","unstructured":"Vincent C, Agard C, Barbarot S, N\u2019Guyen JM, Planchon B, Durant C, et al. Les manifestations buccofaciales de La scl\u00e9rodermie syst\u00e9mique: \u00c9tude de 30 patients cons\u00e9cutifs. Rev Stomatol Chir Maxillofac. 2010;111(3):128\u201334.","journal-title":"Rev Stomatol Chir Maxillofac"},{"key":"526_CR47","doi-asserted-by":"crossref","unstructured":"Crincoli V, Fatone L, Fanelli M, Rotolo RP, Chial\u00e0 A, Favia G et al. Orofacial manifestations and temporomandibular disorders of systemic scleroderma: an observational study. Int J Mol Sci. 2016;17(7).","DOI":"10.3390\/ijms17071189"},{"issue":"1","key":"526_CR48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40268-016-0153-9","volume":"17","author":"A Wolff","year":"2017","unstructured":"Wolff A, Joshi RK, Ekstr\u00f6m J, Aframian D, Pedersen AML, Proctor G, et al. A guide to medications inducing salivary gland Dysfunction, Xerostomia, and subjective sialorrhea: A systematic review sponsored by the world workshop on oral medicine VI. Drugs R D. 2017;17(1):1\u201328.","journal-title":"Drugs R D"},{"issue":"2","key":"526_CR49","doi-asserted-by":"publisher","first-page":"105113","DOI":"10.1016\/j.jbspin.2020.105113","volume":"88","author":"KA Lee","year":"2021","unstructured":"Lee KA, Choi W, Kim J, Kim HS. High prevalence of salivary gland ultrasound abnormalities in systemic sclerosis. Joint Bone Spine mar\u00e7o De. 2021;88(2):105113.","journal-title":"Joint Bone Spine mar\u00e7o De"},{"key":"526_CR50","doi-asserted-by":"publisher","unstructured":"Brito-Zer\u00f3n P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, et al. Sj\u00f6gren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2:16047. https:\/\/doi.org\/10.1038\/nrdp.2016.47","DOI":"10.1038\/nrdp.2016.47"},{"key":"526_CR51","doi-asserted-by":"crossref","unstructured":"Melo JL, Coelho CPeS, Nunes F, Heller PeS, Grisi D, Guimar\u00e3es M do CM, et al. A scoping review on hyposalivation associated with systemic conditions: the role of physical stimulation in the treatment approaches. BMC Oral Health. 2023 Jul 21;23(1):505.","DOI":"10.1186\/s12903-023-03192-8"},{"issue":"1","key":"526_CR52","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/0030-4220(81)90169-9","volume":"52","author":"Y Marmary","year":"1981","unstructured":"Marmary Y, Glaiss R, Pisanty S, Scleroderma. Oral manifestations. oral Surgery, oral medicine. Oral Pathol. 1981;52(1):32\u20137.","journal-title":"Oral Pathol"},{"issue":"8","key":"526_CR53","first-page":"1465","volume":"51","author":"AHL Low","year":"2012","unstructured":"Low AHL, Wong S, Thumboo J, Ng SC, Lim JY, Ng X, et al. Evaluation of a new multi-parallel line immunoassay for systemic sclerosis-associated antibodies in an Asian population. Rheumatol (United Kingdom). 2012;51(8):1465\u201370.","journal-title":"Rheumatol (United Kingdom)"},{"issue":"6","key":"526_CR54","first-page":"931","volume":"15","author":"CH Chu","year":"2011","unstructured":"Chu CH, Yeung CMK, Lai IA, Leung WK, Mok MY. Oral health of Chinese people with systemic sclerosis. Clin Oral Investig 12 De Dezembro De. 2011;15(6):931\u20139.","journal-title":"Clin Oral Investig 12 De Dezembro De"},{"key":"526_CR55","doi-asserted-by":"crossref","unstructured":"Ciurea A, Stanomir A, \u0218urlin P, Micu I, Pamfil C, Leucu\u021ba D, et al. Insights into the relationship between periodontitis and systemic sclerosis based on the new periodontitis classification (2018): a cross-sectional study. Diagnostics (Basel). 2024 Mar 4;14(5):540.","DOI":"10.3390\/diagnostics14050540"}],"container-title":["Advances in Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42358-026-00526-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42358-026-00526-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42358-026-00526-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:37:45Z","timestamp":1781635065000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42358-026-00526-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,21]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["526"],"URL":"https:\/\/doi.org\/10.1186\/s42358-026-00526-2","relation":{},"ISSN":["2523-3106"],"issn-type":[{"value":"2523-3106","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,21]]},"assertion":[{"value":"30 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Western Paran\u00e1 State University\/Unioeste (No. 2,443,066). All the participants signed an informed consent form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}