Idiopathic Granulomatosis in Gingiva: A Challenging Case Report

Introduction: Identifying the etiology and pathogenesis of granulomas in the orofacial region can be challenging as a wide range of disorders are associated with granulomatosis. A diverse range of etiologies, including genetic, immunologic, allergic, and infectious mechanisms, have been implicated in granulomatosis. A comprehensive clinical, microscopic, and laboratory assessment may be necessary to ascertain the underlying cause of granulomatous inflammation. 
Case Report: This case presents a female adolescent patient with idiopathic granulomatosis in the gingiva, lacking any identifiable causative factors. Intraoral examination revealed granular erythematous gingiva, especially in the anterior regions of the maxillary and mandibular arches, and a biopsy was taken 
after initial periodontal therapy. A histopathological examination revealed the presence of a non-caseating granulomatous lesion. Further investigations were conducted to rule out potential causative factors. Subsequent analysis showed no abnormalities in the patient’s general health. 
Conclusion: In the absence of a clear etiological explanation for a given lesion, eliminating the disease and constructing an appropriate treatment plan may prove challenging.