Approach to orofacial granulomatosis and review of literature

Received: 26 June 2011 Accepted: 22 Nov 2011 Abstract Background and Aim: Orofacial granulomatosis (OFG) comprises a group of diseases characterized by non-caseating granulomatous inflammation affecting the soft tissues of the oral and maxillofacial region. Wiesenfeld introduced the term orofacial granulomatosis in 1985 for the first time. The precise cause of OFG is unknown; however, some theories have been suggested including allergy, infection and genetic predisposition. The clinical presentation can be highly variable, making the diagnosis difficult to establish. The aim of this review was to define clinical features, differential diagnosis and treatment protocols of OFG. Materials and Methods: All English articles from 1950 to 2010 in Pubmed, InterScience, ScienceDirect, Google Scholar databases were searched using the keywords: orofacial granulomatosis, approach, and treatment. Persian articles were also selected from Iran Medex. Results and Conclusion: Because of the relatively nonspecific clinical findings associated with a variety of granulomatous diseases, the diagnosis of orofacial granulomatous often presents a dilemma for the clinician. The most common differential diagnosis includes Crohn's disease, sarcoidosis, and infection. However, a variety of other conditions may be associated with granuloma formation. Often an extensive clinical, microscopic, and laboratory evaluation may be required to reach to definite diagnosis and proper treatment.