Rare occurrence of orofacial granulomatosis with deformity in gingiva – unusual case report

Abstract

Persistent soft tissue enlargement in the orofacial region is often considered a feature of a chronic disease, termed as orofacial granulomatosis (OFG). Systemic diseases like crohn's, inflammatory bowel syndrome present OFG as their oral manifestation, but it may also be seen in the absence of these diseases. To the best of the authors' knowledge and literature search, this is the first case of OFG with gingival deformity related to cigarette smoking. A 25-year-old male patient presented with chief complaint of swelling on his upper lip, increase in the size of gingiva and hypersensitivity in the maxillary anterior teeth region. After thorough history of disease initiation in response to cigarette smoking, clinical examination, histopathological findings, the diagnosis of OFG associated with cigarette smoking was made. Treatment included cessation of cigarette smoking, internal bevel gingivectomy, with proper medication. Single treatment modality may not be effective in such cases. Therefore, early and precise diagnosis with sequential treatment including elimination of etiological agent, anti-inflammatory drugs or even plastic surgeries may be required for improving patient's health, appearance and comfort.