Langerhans cell histiocytosis of the jawbone—a lethal condition that might be mistaken for periodontitis: A comprehensive review and report of a case with spontaneous regression – Group License

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Langerhans cell histiocytosis (LCH) is a rare disease of unknown pathogenesis that involves clonal proliferation of Langerhans cells and can affect multiple human body systems. LCH’s presentation in the jaws is often mistaken for severe periodontal disease because of the bone loss pattern and attendant tooth mobility mimicking that of periodontal disease. The purpose of this article is to review the literature to highlight current diagnostic and therapeutic strategies for LCH in the jawbone. In addition, a case with spontaneous regression of an apparent isolated focal presentation of LCH in the mandible of a young man is presented. After performing a diagnostic biopsy, a conservative “wait and see” approach for treating LCH in jaws is suggested. Based on the available clinical evidence, monitoring of similar cases for a longer period is reasonable before drawing further conclusions.

Educational objectives

Upon completion of this course, the dental professional should be able to:

Identify the dental and systemic clinical features of Langerhans cell histiocytosis

Distinguish LCH from periodontal and endodontic lesions

Describe the different modalities utilized for the management of involved teeth

Identify the team members who should be involved in treating such cases

About the Authors

Hussein S. Basma, DDS, DESS, MS, is an assistant professor in the Department of Periodontology at the University of Alabama at Birmingham. He is a diplomate in the American Board of Periodontology, and lectures nationally and internationally about periodontology and implant dentistry. Dr. Basma has authored numerous peer-reviewed scientific articles and abstracts. His teaching efforts focus on bone augmentation, full-arch rehabilitation, multidisciplinary care, and integration of technology.

Muhammad H. A. Saleh, BDS, MS, MSD, is a clinical assistant professor at the University of Michigan School of Dentistry Department of Periodontics and Oral Medicine. He is actively involved in research, serving as a peer reviewer and publishing more than 50 periodontics and implant-related peer-reviewed articles. A winner of multiple national and international awards, Dr. Saleh’s research interest is primarily focused on risk factors of periodontitis and peri-implantitis, and guided bone regeneration.

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