Clinical and Demographic Characteristics of Oral Sarcoidosis: A Systematic Review of Case Reports and Case Series

TL;DR

This study reviews oral sarcoidosis cases to compare characteristics of those with and without jaw bone involvement, highlighting the importance of early diagnosis and multidisciplinary care.

Contribution

The paper provides the most extensive analysis of oral sarcoidosis, identifying two distinct clinical entities based on bone involvement.

Findings

Patients with bone involvement showed symptoms like loose teeth and bone loss, while non-bone cases had soft tissue symptoms like swelling.

Female predominance was observed in both bone-involved and non-bone-involved sarcoidosis cases.

Surgical intervention and steroid therapy were common treatments, with favorable outcomes in most cases.

Abstract

Background/Objectives: Sarcoidosis is a granulomatous disorder of unknown etiology that can affect multiple organs, including the oral cavity. This study aimed to compare the clinical and demographic characteristics of sarcoidosis cases with and without bone involvement in the jaw. Methods: A systematic review of the case reports and case series of sarcoidosis in the oral cavity between 1943 to 2024 were analyzed. Variables assessed included age, sex, presenting symptoms, duration of symptoms, diagnosis methodology, treatment approaches, and outcomes. Results: A total of 59 studies reporting 77 patients were included, with a mean age of 43.3 yrs. Female predominance was noted in both, bone-involved (61.5%) and non-bone-involvement cases (72.5%). Patients with bone involvement often presented with localized symptoms such as loose teeth (34.6%), bone loss (69.2%), and nasal obstruction (15.4%), whereas non-bone-involvement cases frequently exhibited soft tissue manifestations, like swelling (38%) and bleeding (14%). Treatment typically involved surgical intervention and steroid therapy in both groups, with favorable outcomes achieved in most cases. Conclusions: This systematic review presents the most extensive analysis of oral sarcoidosis. Oral sarcoidosis presents as two distinct clinical entities based on bone involvement. Soft tissue lesions often serve as an early diagnostic clue for systemic disease, while bony manifestations suggest a later, more destructive complication. Recognizing this dichotomy is crucial for dentists and clinicians to ensure timely diagnosis and appropriate referral, and this underscores the oral cavity’s critical role as an indicator of systemic illness and mandates a multidisciplinary management strategy.

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