The Progress And Case Reports Of Diagnosis And Treatment On Orofacial Granulomatosis

[Purpose]Preliminary discussion the important role of the oral lesions in the development and treatment of the Orofacial Granulomatosis.The differences in etiology,clinical manifestation,diagnosis,treatment and prognosis of Orofacial Granulomatosis were described and discussed in order to provide guidance for clinical diagnosis and treatment.[Method]Collected 42 patients diagnosed with Orofacial Granulomatosis who were treated in Stomatological hospital of Shandong University from July 2014 to February 2017,there were 20 male cases and 22 female cases,aged 15-69 years old,and rule out significant systemic disease,such as diabetes,high blood pressure,heart disease and so on.Lip swelling are founded in 40 cases,of which upper lip swelling in 6 cases,lower lip swelling in 10 cases,lips swelling in 7 cases,lips swelling associated with facial paralysis or cleft tongue in 3 cases,lips swelling with labial or buccal nodular changes in 12 cases,lips swelling with other parts of the atypical behavior such as gums in 2 cases;buccal nodular changes in 2 cases.We adopted different methods of treatment,removal of oral lesions all achieved good results.[Results]42 patients with Orofacial Granulomatosis had chronic apicitis in 40 cases,periodontitis in 15 cases,pericoronitis in 4 cases,chronic pulpitis in 3 cases,of which only chronic apicitis in 20 cases,only periodontitis in 1 case,only pericoronitis in 1 case,chronic apicitis and periodontitis in 14 cases,chronic apicitis and pericoronitis in 3 cases,chronic apicitis and chronic pulpitis in 3 cases.The symptoms disappeared in 25 cases and decreased in 17 cases after removal of oral lesions,such as root canal therapy,dental extraction,periodontal treatment and necessary apical surgery.The symptoms disappeared and make a good clinical effect after further treatment,such as the application of antihistamines and thalidomide and the local application of tacrolimus.[Conclusion]Orofacial granulomatosis is an uncommon chronic granulomatous condition with a multifactorial etiology and pathogenesis.Its etiology is not clear,genetic,allergic,immunologic,and infectious mechanisms have been implicated,the oral lesions such as chronic apicitis,periodontitis,pericoronitis and chronic pulpitis as important infection factors plays an important role in the development of Orofacial Granulomatosis.Its clinical manifestations are diverse,but the lips swelling of granulomatous cheilitis is the most common performance.Its diagnosis is more complicated,careful clinical examination,imaginology examination and histopathological examination can help face the correct diagnosis and distinguishe from the systemic disease,such as sarcoidosis,crohn's disease,etc.Its treatment also take non-surgical methods for the etiology and symptomatic.Early and accurate diagnosis and removal of the lesions for those patients with clear oral lesions,the prognosis is generally good.