Orthodontic treatment of three patients with systemic lupus erythematosus (SLE) in a multidisciplinary approach

Systemic lupus erythematosus (SLE) is an autoimmune disease-causing inflammation. The impact of SLE pathology and treatment drugs on orthodontic treatment has not been closely examined. We report three cases of orthodontic treatment in patients with SLE. Patient 1: A 16-year-6-month-old female patient presented with an anterior crossbite. She had been receiving treatment with immunosuppressants, systemic steroids, and bisphosphonates (BP). Following BP withdrawal, the left maxillary deciduous canine was extracted, and she was treated with preadjusted edgewise appliances for 1 year and 2 months. Patient 2: A 33-year-4-month-old female patient presented with anterior crowding. She had been receiving immunosuppressive and systemic steroids treatment. After the withdrawal of immunosuppressants and administration of antibiotics, the maxillary and mandibular first premolars were extracted bilaterally, and she was treated with preadjusted edgewise appliances for 4 years and 4 months. Patient 3: A 24-year-9-month-old female patient presented with anterior crowding. She had been receiving immunosuppressants and systemic steroids treatment. The maxillary first premolars were extracted bilaterally under antibiotic coverage, and she was treated with preadjusted edgewise appliances for 2 years 11 months. In all cases, multidisciplinary approaches were employed, and favorable occlusion was established without SLE flare-ups. Although this report only involved three patients, the findings suggested the importance of starting orthodontic treatment during the remission phase of SLE, administering antibiotics prophylactically before tooth extraction, ensuring thorough oral hygiene management, and monitoring the morphology of the temporomandibular joint and root resorption. Further research is warranted to better understand the oral health of patients with SLE.