Abstract: Abnormal oral mucosal light reflectance: A new clinical sign of Ehlers-Danlos syndrome

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Abnormal oral mucosal light reflectance: A new clinical sign of

Ehlers-Danlos syndrome

Stefano Parrini DDS, PHD , , a, Bellosi MS b, Alessandro Barducci MS

c, Giorgio Bianciardi BS, MD, PhD d, Giuseppe Latini MD e and Claudio De

Felice MD f

a Researcher and Oral Surgeon, Department of Odontostomatological Sciences,

University of Siena, Italy

b Researcher, Orintex srl, Prato, Italy

c Researcher and Professor of Physics, Department of Information

Engineering, University of Siena; Institute of Applied Physics " Nello

Carrara, " National Research Council of Italy, Florence, Italy

d Researcher, Department of Human Pathology and Oncology, University of

Siena, Italy

e Head, Division of Neonatology, Perrino Hospital, Brindisi; Clinical

Researcher, Clinical Physiology Institute, National Research Council of

Italy, Lecce Section, Italy

f Hospital-based Neonatologist and Clinical Researcher, Neonatal Intensive

Care Unit, Azienda Ospedaliera Universitaria Senese, Italy

Editor: S. Greenberg University of siena, national research council

of italy, and perrino hospital Available online 5 March 2004.

Abstract

Ehlers-Danlos syndrome (EDS) is a major inherited connective tissue disorder

leading to an impaired extracellular matrix structure. Although several

odontostomatologic signs have been reported, their diagnostic accuracy

remains to be ascertained. We tested the hypothesis that EDS is associated

with an abnormal reflectance of the oral mucosa. Twelve patients with EDS-II

or EDS-III and 12 age- and gender-matched controls were examined.

Reflectance of the lower gingival and vestibular oral mucosa in the optical

spectrum was measured using an imaging spectrophotometer. EDS patients

showed significantly higher reflectance values in the 400-590 nm wavelengths

(P.0002) and significantly lower reflectance values in the red wavelengths

(610-700 nm range, P.025) than did controls. A reflectance cutoff value of

>10.51% at the 400 nm wavelength identified the EDS patients with 100%

sensitivity and 100% specificity. These findings indicate that an abnormal

oral mucosal reflectance is a previously unrecognized clinical marker of

EDS.

Corresponding author. Reprint requests: Stefano Parrini, DDS, Department of

Odontostomatological Sciences, University Medical School, Policlinico " Le

e " , Viale M. Bracci, 16, I-53100 Siena, Italy.