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Orofacial granulomatosis: review on aetiology and pathogenesis

Authors

  • W. M. Tilakaratne,

    1. Centre for Research in Clinical and Diagnostic Oral Sciences, The School of Medicine and Dentistry, Queen Mary, University of London, London, UK
    2. Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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  • J. Freysdottir,

    1. Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik Iceland
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  • F. Fortune

    1. Centre for Research in Clinical and Diagnostic Oral Sciences, The School of Medicine and Dentistry, Queen Mary, University of London, London, UK
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Prof WM Tilakaratne, Professor and Consultant in Oral Pathology, Head/Division of Oral Pathology Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. Tel: 94 8 2387666, Fax: 94 8 2388948, E-mail: wmtilak@pdn.ac.uk

Abstract

Orofacial granulomatosis (OFG) is considered as an uncommon disease and nomenclature of the disease was subjected to debate for a long time. Although various aetiological agents such as food substances, food additives, dental materials and various microbiological agents have been implicated in the disease process its precise pathogenesis is yet to be elucidated. Delayed type of hypersensitivity reaction appears to play a significant role, although the exact antigen inducing the immunological reaction varies in individual patients. However, evidence for the role of genetic predisposition to the disease is sparse. The underlying immunological mechanism appears to show some similarities between OFG and Crohn’s disease, emphasizing the need for more comparative studies of the two entities. Therefore, we propose the term idiopathic OFG as a better term for those cases restricted to oral region without any identifiable known granulomatous disease and the diagnosis should not be changed until the patient develops systemic manifestations of a specific granulomatous condition. This review attempts to discuss the role of different aetiological agents and certain aspects of pathogenesis of OFG.

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