Immunoglobulin G4–related sclerosing disease involving the mandible
Hong Kong Medical Journal
A 46-year-old female was referred by her general dental practitioner in December 2013 for investigation of delayed healing of lower right premolar (44, 45) socket wounds following tooth extraction 3 weeks earlier. The lower right first and second premolars-teeth 44, 45-had presented with sudden onset of pain and rapid increase in mobility over a 2-month period. Both teeth were subsequently extracted but the patient experienced increasing pain and discomfort around the extraction sites. Clinical
... ion sites. Clinical examination showed unhealed sockets of teeth 44, 45; with associated flabby, oedematous and verrucous gingival tissue (Fig 1) . The lower right canine tooth demonstrated grade III mobility with radiographic evidence of periodontal bone loss. The provisional diagnoses included eosinophilic granuloma or Langerhans cell histiocytosis, massive osteolysis, and malignancies. Incisional biopsy was performed under local anaesthesia. Histopathological examination revealed infiltration by chronic inflammatory cells involving the epithelium and stroma, with absence of malignancy.