Introduction: The C.R.E.S.T. Syndrome is the limited variant of systemic sclerosis (SS) an autoimmune multisystemic disease characterized for its increased accumulation of collagen in blood vessels, skin, and several organs that causes progressive general deterioration. Although it has a small prevalence in the general population and the literature associated to maxillofacial surgery is few, has a profound impact in both oral and maxillofacial surgery.

Objectives: The presentation of this case allows to illustrate the implication of C.R.E.S.T in oral health and the possible complications that may show in the eventuality of surgery. Also contributes the few literature available regarding this subject.

Presentation of the case: 70 years old patient, treated at the Padre Hurtado Teaching Hospital, with 10 years evolution of C.R.E.S.T. Syndrome, pulmonary fibrosis, cardiopathy, G.I. disorders, water melon stomach, hypertension, diabetes, psychological disorders. Referred from Cardiology for numerous dental septic foci.

Conclusions: Common oral manifestation include xerostomia, microstomia, tongue rigidity, poor oral hygiene, and in more severe cases, nasal alae atrophy, widened palpebral fissures, pathologic fractures developed from mandibular resorption. This manifestation, associated to sclerodactyly and musculoskeletal disorders, often lead to oral sepsis and recurrent infections.

The high morbidity and the diverse pharmacology used to treat this patients symptoms, implicates a complication in the treatment of orofacial pathologic processes, and the risk of unwanted complication.

Conflict of interest: None declared.