Oral features of Wegener's granulomatosis

A review of the dental literature yielded ten cases of Wegener's granulomatosis manifesting in the oral cavity, but only one was found in the medical literature. The most common oral lesion is hyperplastic gingiva, which is red to purple, with many petechiae. Tooth mobility, loss of teeth, and failure of wounds to heal are also common manifestations. The disease may remain localized in the oral cavity for unusually long periods of time before multiorgan involvement occurs. Histologically, oral biopsy tissue does not exhibit the characteristic features of vasculitis and granulomas. There are, however, diagnostic histologic features that are consistently present, including pseudoepitheliomatous hyperplasia, epithelioid histiocytes, giant cells, and eosinophils. Failure to recognize these diagnostic clinical and histologic features resulted in a 24-month delay in the diagnosis and treatment of our patient.