Épulis congénito

Introducción: El épulis congénito es un tumor benigno muy poco frecuente de etiología desconocida. Se presenta principalmente en la cresta del reborde alveolar, cerca de la región canina. Su tamaño es variable y puede llegar a ocupar toda la cavidad oral. La prevalencia es mayor en el maxilar superior y en el sexo femenino. Objetivo: Examinar la literatura en relación con el diagnóstico y tratamiento del épulis congénito a propósito de la presentación de un caso clínico poco frecuente. Presentación del caso: Paciente femenina, de 5 días de vida, que ingresa con aumento de volumen polilobulado, de 1 cm de diámetro, ubicado en reborde alveolar superior izquierdo, rojizo, de consistencia firme, base pediculada, que ocasionaba dificultades en la alimentación. No se identificaron otras alteraciones. Por la clínica y la naturaleza congénita de la entidad se planteó el diagnóstico de épulis congénito y se realizó la excéresis quirúrgica bajo anestesia general. El diagnóstico histopatológico se correlacionó con los hallazgos clínicos y reveló épulis congénito. Conclusiones: El épulis congénito es un tumor benigno muy poco frecuente. No existe consenso entre los autores en relación con su patogenia e histogénesis. El tratamiento indicado es la excéresis quirúrgica en el momento del nacimiento, principalmente cuando interfiere en la alimentación y la respiración. El diagnóstico precoz y tratamiento oportuno eliminan completamente la lesión y las complicaciones asociadas a este tumor.

Introduction: Congenital epulis is a very rare benign tumor of unknown etiology. It occurs mainly on the crest of the alveolar ridge, near the canine region. Its size is variable and can occupy the entire oral cavity. The prevalence is higher in the upper jaw and in the female sex. Objective: To examine the literature related to the diagnosis and treatment of congenital epulis regarding the presentation of a rare clinical case. Presentation of the case: Female patient, 5 days old, who is admitted with an increase in polylobed volume, 1 cm in diameter, located in the left upper alveolar ridge, reddish, of firm consistency, pediculate base, which caused difficulties in feeding. No other alterations were identified. Due to the clinical and congenital nature of the entity, the diagnosis of congenital epulis was stated and surgical exeresis was performed under general anesthesia. Histopathological diagnosis was correlated with clinical findings and revealed congenital epulis. Conclusions: Congenital epulis is a very rare benign tumor. There is no consensus among the authors regarding its pathogenesis and histogenesis. The indicated treatment is surgical exeresis at the time of birth, mainly when it interferes with feeding and breathing. Early diagnosis and timely treatment completely eliminate the lesion and complications associated with this tumor.

The Prosthetic Management of a Case of Epulis Fissuratum by a Novel Technique / El manejo protésico de un caso de épulis fisurado con una técnica novedosa

ABSTRACT: The clinical management of the epulis involves the elimination of causal factors, excision of fibrous tissue excess accompanied by an appropriate prosthetic rehabilitation. The confection of interim prosthesis or the rectification of old prosthesis for the setting up of a tissue conditioner if necessary, to improve the healing and prevent the decrease of the vestibule depth after the surgical exeresis. Throughout this paper, we are going to present a new technique for the correction of old prostheses poorly adapted for the management of a case of the epulis fissuratum.

RESUMEN: El manejo clínico de un épulis comprende la eliminación de los agentes causales y la eliminación del tejido fibroso, acompañado de una adecuada rehabilitación protésica. Es necesaria la confección de una prótesis provisional o la rectificación de la prótesis vieja, para la colocación del acondicionador de tejidos si fuera necesario para mejorar el sanado y prevenir la disminución de la profundidad del vestíbulo después de la exéresis quirúrgica. En este artículo, presentaremos una nueva técnica para la corrección de la prótesis desajustada en el manejo de un caso de épulis fisurado.

A rare case of Angiofibroma mimicking Fibrous Epulis in Posterior Gingival Mucosa

@#Angiofibromas are highly vascular, locally aggressive but histologically benign tumors. A 40-year-old woman complaint of pedunculated mass in the right gingiva of the posterior region since 7 months earlier. Surgical excisional biopsy under general anesthesia was performed. Histopathological examination showed an angiofibroma. Angiofibromas are localized in the superficial soft tissue and the gingiva could have a similar clinical appearance as an epulis. Definitive diagnosis was determined through histopathological analysis.

Granuloma periférico de células gigantes asociado a un implante: informe de un caso clínico con seguimiento a 5 años / Implant-associated peripheral giant cell granuloma: a case report with 5-year follow-up

Objetivo: Presentar la respuesta clínica a largo plazo del tratamiento de un granuloma periférico de células gigantes en un implante oseointegrado en el maxilar inferior. Caso clínico: Un paciente de 60 años, de sexo masculino, sin antecedentes sistémicos, concurrió por una lesión con márgenes definidos, de color rojizo morado y consistencia blanda sobre los tejidos blandos en la cara vestibular de un implante colocado en zona de 46. Se realizó la escisión quirúrgica de la lesión, se procesó el tejido extirpado y se envió al laboratorio. El estudio anatomopatológico confirmó el diagnóstico de granuloma periférico de células gigantes. La lesión recidivó dos veces. En la tercera extirpación se realizó la implantoplastía de la superficie del implante. La cicatrización no presentó inconvenientes. Hasta el último control, a los 5 años, no volvió a haber recidiva. Conclusión: En este caso clínico, se logró mantener la salud periimplantaria durante 5 años luego de la eliminación de un granuloma periférico de células gigantes. No obstante, este tuvo que ser removido en tres oportunidades debido a la alta recidiva (AU)

Aim: To evaluate the long-term clinical response to the treatment of a peripheral giant cell granuloma in an osseointegrated implant in the lower jaw. Clinical case: A 60-year-old male patient, with no systemic medical problems, presented a soft tissue lesion located at the buccal aspect of an implant placed in the 46 area. The lesion had defined reddish-purple margins and soft consistency. Surgical excision of the lesion was performed, processed and sent to the laboratory. The histopathology confirmed the diagnosis of peripheral giant cell granuloma. The lesion recurred twice. During the third surgical removal an mplantoplasty of the implant surface was performed. The healing was uneventful and there was no recurrence until the last control at 5 years. Conclusion: In this clinical case, perimplantar gingival health was maintained for 5 years after the surgical removal of a giant cell peripheral granuloma. However, it had to be removed three times, demonstrating a high recurrence (AU)

Treatment strategy for pregnancy epulis / 华西口腔医学杂志

Pregnancy epulis is a tumor-like lesion with high prevalence in China. The local lesion, the general condition of the pregnant patient, and the complications during treatment should be taken into consideration when making a treatment plan for pregnancy epulis. In this study, three representative pregnancy epulis cases were presented, and related studies at home and aboard were reviewed to summarize the etiology, differential diagnosis, treatment, and prevention of pregnancy epulis and share the clinical experience in the treatment of pregnancy epulis.

Clinical evaluation and comparison of three surgical procedures for treatment of root surface exposure after epulis resection / 中华口腔医学杂志

Objective@#To evaluate and compare the clinical effects of three surgical procedures for the periodontal treatment of root surface exposure after resection of epulis.@*Methods@#Thirty patients with epulis were selected in this study and the exposed root surfaces of the patients′ teeth were covered with laterally transposition flap, laterally pedicled transposition flap or coronally advanced flap combined with a connective tissue graft in the treatments of epulis. At the time of follow-up during the operation, 3 months after operation and 6 months after operation, respectively, the color, shape and quality of the gum in the operation area and the coordination of the diaphragm and diaphragm were observed, and the root surface exposure (recession depth, RD) and angle were recorded. Keratinized tissue height (KTH), root coverage rate (RC) and patients′ satisfaction with the surgery were also recorded.@*Results@#The flap widths in groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft were significantly wider than that in the group of laterally transposition flap at three-month and six-month follow-ups after the surgery. The width of keratoderma [(2.70±1.16) mm] in the group of laterally transposition flap was significantly lower at 6 months postoperatively than that in the other two groups [(4.80±1.14) and (4.90±1.66) mm, respectively] (P<0.01). At the 6th month after surgery, the root flap coverage was at the lowest level [(24±43)%] in the group of laterally transposition flap, and it was significantly lower than that in the other two groups [(80±23)% and (86±24)%, respectively] (P<0.01). There was no significant difference of the root flap coverage between groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft. At the time of follow-up, patients were satisfied with the aesthetic effects of the three surgical procedures.@*Conclusions@#After the resection of the gingival tumor, the defect of the gingiva is caused. The laterally pedicled flap and pedicled flap combined with connective tissue transplantations for soft tissue repairing can achieve satisfactory aesthetic effects which are superior to the effect of simple flap technique.

Localised Gingival Overgrowth- Issues Revisited

A variety of localised gingival overgrowths are encountered by a clinician on a regular basis, specially a dentist encounters such growths very frequently; although all the growths show similar clinical features, it is their histological features which are different for each type of growths. Though ignored in daily practice, but histological examination is the only method to form the correct diagnosis avoidance of which could sometimes lead to ignoring serious consequences like malignancies. This article reviews and presents three cases of such growths i.e. Peripheral odontogenic fioma which is a rare benign odontogenic neoplasm, Fioid and Pyogenic granuloma. It stresses upon the importance of histopathological examination of all such gingival conditions, and how it is ignored and should be mandatory for such cases.

Multiple pregnancy epulides: a case report / 华西口腔医学杂志

Pregnancy epulis is a tumor-like lesion that results from aggravating gingivitis due to high level of gonadal hormone concentration. Pregnancy epulis is commonly manifested as a single lump. A case of multiple pregnancy epulises, which has been rarely explored, is reported in this paper. The patient received no other treatment but a single supragingival scaling. Results showed no remarkable changes in the lesion. However, all the epulides regressed spontaneously in five months after the parturition.

Fibrous Epulis Misdiagnosed for Combined Periodontic-Endodontic Lesion

Fibrous epulis or peripheral ossifying fibroma is a reactive non-neoplastic condition that affects the gingiva as a result of chronic irritation. A case of a 44 year old female is presented in this study with a gingival swelling related to the maxillary central incisors. The Patient reported a history of trauma ten years ago and a recent root canal treatment of tooth 21, followed by referral to a specialist with a misdiagnosis for a combined periodontic-endodontic lesion affecting the maxillary central incisors. Excisional biopsy of the lesion revealed a diagnosis of ulcerated fibrous epulis with osseous metaplasia also known as peripheral ossifying fibroma. Periodontal debridement was performed to eliminate supra and subgingival plaque and calculus as well as gingival inflammation that could have been the source of irritation. The clinical and histopathological pictures and the surgical procedures associated with management of the periodontal disease are described. The etiological factor behind the development of the gingival reactive lesion remains unknown and could be the history of trauma, the chronic irritation induced by the plaque and calculus associated with the periodontal disease or a combination of both. We endeavour to follow up the case in order to report any recurrence

Clinical effect evaluation of palatal free gingival flaps restoration applied to anterior maxillary gingival defect after epulis resection / 口腔疾病防治

Objective@#To evaluate the effect of palatal free gingiva in anterior maxillary defect restoration after epulis resection. @*Methods@# 22 cases were included in this study. Palatal free gingival flap was prepared to restore anterior maxillary defect after epulis resection. Clinical effect was evaluated according to gingival margin, gingival papilla index and modified sulcus bleeding index. @*Results @#Satisfactory clinical effect was achieved in all 22 cases, with adequate height, thickness, fullness and texture. @*Conclusin @#Palatal free gingival flap was clinically effective in anterior maxillary defect treatment after epulis resection, with satisfactory aesthetic clinical effect.

Granuloma periférico de células gigantes: revisión de 87 casos / Peripheral giant-cell granuloma: a review of 87 cases

El granuloma periférico de células gigantes (GPCG) es una hiperplasiareactiva que se presenta sólo en la encía como respuesta a una irritación local o trauma crónico, sin predilección de género y edad variable. Objetivo: Identifi car las características demográfi cas e histopatológicas de 87 casos de GPCG en un servicio privado de patología bucal. Metodología: Se obtuvieron los datos de edad, género y diagnóstico clínico de 87 casos de GPCG. Se analizó la distribución por género y edad. Los cortes histológicos fueron examinados para confirmar el diagnóstico en 84 casos, ya que tres no presentaron las características del GPCG. Las características histopatológicas que se evaluaron fueron la presencia de estroma hipercelular, infi ltrado infl amatorio crónico, hemorragia, hemosiderina, tejidos mineralizados y úlcera. Resultados: De los 87 casos, tres fueron descartados por no corresponder al diagnóstico. En un periodo de 10 años se recibieron 6,696 biopsias, de las cuales 84 (1.2 por ciento) correspondieron a GPCG. Se presentó en un rango de edad de cinco a 90 años, con una media de edad de 42 años (± 19.9), siendomás frecuente en la quinta década de la vida y mostró predilección por el género femenino (58.5 por ciento). En los cortes histológicos se observó un estroma hipercelular con células de forma ovoide o fusiforme y células gigantes multinucleadas tipo osteoclasto, infi ltrado inflamatorio(66 por ciento), hemorragia (85 por ciento), hemosiderina (20 por ciento), tejidos mineralizados (11.9 por ciento) y úlcera (25 por ciento). Conclusión: El GPCG es una lesión exofítica reactiva de la encía que presenta características demográficas variables y que al examen microscópico se distingue por tener células gigantes multinucleadas tipo osteoclasto, además de otros componentes como tejidos mineralizados.

The peripheral giant-cell granuloma (PGCG) is a reactive hyperplasiathat occurs only in the gum, in response to local irritation orchronic trauma, with no predilection for either age or sex. Objective:To identify the demographic and histopathological characteristics of87 cases of PGCG in a private oral pathology service. Methodology:Data on the age, gender, and clinical diagnosis of 87 cases of PGCGwere obtained, which were analyzed to determine the distributionby sex and age. Histological sections were examined to confirm thediagnosis in 84 of the cases (three did not present any characteristicsof PGCG). The histopathologic features were evaluated for the presence of hypercellular stroma, chronic infl ammatory infi ltrate,hemorrhaging, hemosiderin, mineralized tissues, and ulcers. Results: of the 87 cases, 3 were eliminated as they did not match the requireddiagnosis. Over a 10-year period, 6,696 biopsies were received bythe pathology service, of which 84 (1.2%) were of PGCG. This was presented in patients ranging from 5 to 90 years old, the mean agebeing 42 years (± 19.9); it occurred most frequently in the 5th decadeof life and showed a predilection for females (58.5%). In the histologicsections, a hypercellular stroma with ovoid or fusiform cellsand multinucleated osteoclast-like giant cells was observed, as wellas infl ammatory infi ltrate (66%), hemorrhaging (85%), hemosiderin(20%), mineralized tissues (11.9%), and ulcers (25%). Conclusion:The PGCG is a reactive exophytic lesion of the gingiva that presentsvariable demographic features and which, under microscopic examination, is distinguished by multinucleated osteoclast-like giant cells, and other components as mineralized tissues.

Congenital epulis: A rare benign tumour

Congenital epulis is a rare benign pedunculated tumour of the oral cavity arising from the alveolar ridges. It is usually detected in newborns and can be successfully resected surgically. We report a case of a newborn baby who had a 5x3x3cm pedunculated lobar mass arising from the upper alveolar ridge.

Peripheral giant cell granuloma: a case report

Peripheral giant cell granuloma (PGCG) is a non neoplastic reactive lesion of the gingiva, originating from the periosteum or periodontal membrane following local irritation or chronic trauma. PGCG manifests as a red-purple growth located in the gingiva or edentulous alveolar margins. The lesion can develop at any age, shows a slight female predilection. Usually, they cause one or the other problem in eruption or alignment of teeth, but may also present without disturbing the normal occlusion or eruption pattern. Management of these teeth depends on the symptoms. Presented here is a case of PGCG in relation to the lower right first premolar in a 10 year old child.

Épulis congénito del recién nacido, una sorpresa para el Neonatólogo / Congenital epulis of the newborn, a surprise to the neonatologist

RESUMEN El épulis congénito del recién nacido es un tumor benigno, pediculado, de consistencia firme y tamaño variable, poco frecuente, de presentación bucal que tiene predilección por el sexo femenino. Se localiza habitualmente en la zona anterior y superior del maxilar superior. En caso de ser de gran tamaño puede interferir en la alimentación y dificultar la alimentación del neonato. La resección quirúrgica es el mejor tratamiento. El presente trabajo expone un caso y hace una revisión de la literatura.

ABSTRACT The congenital epulis of the newborn is a benign tumor, pedunculated, with a hard consistency and variable size rare, oral and of presentation that has a predilection for females. It is usually located in the anterior and superior maxilla. In case of big size it can interfere with feeding and can cause difficult neonatal feeding. Surgical resection is the best treatment. In this paper we presents a case and a review of the literature.

Congenital epulis: immunohistochemical findings of 12 cases

Congenital epulis is a fairly rare soft tissue tumour occurring exclusively on the alveolar ridge of newborns. The exact origin of congenital epulis is still debatable. The objective of the study is to determine the clinicopathological features and immunohistochemical findings of congenital epulis. A retrospective study was carried out to determine the clinicopathological features of congenital epulis, diagnosed histologically in the main oral histopathology laboratory in Malaysia from 1967 to 2014. Immunostaining using vimentin, muscle specific actin, smooth muscle antigen, desmin, S100, CD34, CD68 and CD1a was carried out. Twelve cases of congenital epulis were reviewed. All of the patients were females and the presentation age ranged from 2 to 90 days. The patients comprised of 6 Malays, 3 Chinese, 2 Indians and 1 Orang Asli. Most of the cases (n=7) involved the maxillary ridge and presented as pedunculated well-defined lumps (n=8). Excisional biopsy was performed in all cases. Via immunohistochemistry, vimentin expression was observed in all cases; but negative for CD34, muscle specific actin, smooth muscle antigen, and desmin. CD1a and S100 positivity was seen in five cases. The interstitial cells were highlighted by CD68. Although congenital epulis has been first described 130 years ago, the exact nature of its histogenesis remains a mystery.

Granuloma piógeno: presentación inusual en embarazo / Pyogenic granuloma: unusual presentation in pregnancy

El Granuloma piógeno (GP), es una lesión vascular benigna común en piel y mucosas, que se incluye en la clasificación de anomalías vasculares de la “International Society for the study of vascular anomalies (ISSVA)”, dentro de “otros” tumores vasculares, a pesar de su controversial denominación y su patogenia “reaccional”. Presentamos un caso de granuloma piógeno en una paciente de 18 años de edad, en el segundo trimestre de embarazo con una presentación atípica por su gran tamaño y localización acral, con excelente respuesta al tratamiento quirúrgico.

Pyogenic Granuloma (GP) is a common vascular lesion of the skin and mucous membranes, usually presented as a solitary neoplasm with a bright red, smooth surface; usually sessile or pedunculated that grows rapidly to reach 1 to 2 inches in a few weeks and then remains stationary. It is included in the classification of vascular anomalies of the International Society for the study of vascular anomalies (ISSVA) to under "other" vascular tumors despite their controversial name and their "reactional" pathogenesis. Our goal is to present a case of pyogenic granuloma in an 18-year-old rural worker in the 2nd trimester with an atypical presentation for its size (4 x 4 cm) and acral location with excellent response to surgery and emphasize that such damage can result from repeated trauma, impaired wound healing and neovascularization and overexpression of the growth factor vascular endothelial (VEGF) at this period of life.

Congenital epulides: A rare case report.

Congenital epulis (CE) or “Granular cell epulis” also previously termed as “Neumann’s tumor” is a benign growth arising from the mucosa of the gingiva, typically seen as a mass protruding from the infant’s mouth, often interfering with respiration and feeding. These tumors generally present as a single mass arising from the upper alveolus. We report a rare case of two congenital epulides arising from the maxillary and mandibular alveolus in a day old female infant, which was surgically excised, allowing for early initiation of breast feeding. The tumor cells stained negative for S100 protein hence differentiating from other granular cell tumors. The clinical presentation, differential diagnosis in regard to the various neonatal oral swellings and the management of CE has been discussed.

Granuloma periférico de células gigantes: recidiva postquirúrgica. Revisión de la literatura y reporte de un caso clínico / Giant cell peripheral granuloma: post-surgical recurrence. Literature review and clinical case report

El granuloma periférico de células gigantes se define como una lesión de tejidos blandos no neoplásica, ocasionada por una reacción hiperplásica como consecuencia de un traumatismo o inflamación local. Clínicamente se observa como un nódulo asintomático, generalmente de coloración rojiza azulada de diámetro variable y que afecta frecuentemente la encía marginal. Histológicamente se caracteriza por la proliferación de células gigantes mononucleadas y multinucleadas. En general, su tratamiento consiste en la exéresis quirúrgica más legrado de las paredes óseas afectadas, pudiendo existir la posibilidad de recidiva. A continuación se presenta una revisión de la literatura y se describe un caso clínico diagnosticado como granuloma periférico de células gigantes en un paciente de 14 años, cuya lesión fue removida quirúrgicamente utilizando electrobisturí, y con recidiva de la lesión. Se discute la epidemiología, características clínicas, radiográficas e histológicas de dicha patología, así como las posibles opciones terapéuticas y protocolos. Además, se comentan brevemente los aspectos relacionados al diagnóstico diferencial de las lesiones reactivas hiperplásicas del complejo periodontal, priorizando las posibles causas de la recidiva.

Giant cell peripheral granuloma is defined as a non-neoplastic soft-tissue lesion caused by a hyperplastic reaction resulting from trauma or local inflammation. Clinically it can be observed as an asymptomatic nodule, generally exhibiting a reddish-bluish hue and variable diameter. It frequently affects marginal gingival tissue. Histologically, it is characterized by the proliferation of mono-nucleated and multi-nucleated giant cells. In general, treatment consists of surgical extirpation and curettage of affected bone walls. Recurrence is a distinct possibility. In the present paper, a scientific literature review is presented along with the presentation of a clinical case of a 14 year old patient diagnosed with Giant cell peripheral granuloma: the lesion was surgically removed using an electric scalpel. The lesion recurred 4 weeks after surgery. Epidemiology of the case was reviewed, along with its clinical, radiographic and histological characteristics. Available therapeutic options and protocols were equally reviewed as well as issues related to differential diagnosis of hyperplastic reactive lesions of the periodontal complex. Priority was given to the causes of the lesion's recurrence.

Granular Cell Epulis of a Newborn Male Child.

Congenital granular cell epulis is an uncommon benign tumor arising from alveolar ridges of the newborn sometimes interfering with mouth closure and feeding and when multiple the tumor may cause respiratory obstruction. It is mostly composed of nests of cells with granular cytoplasm set in a prominent vasculature. Here we report a case of CGCE observed in a newborn male due to its rare occurrence, with a brief review of literature pertaining to its histogenesis and differentiation from its adult counterpart.

Denture induced inflammatory hyperplasia – a case report

Epulis fissuratum is a benign tumor like inflammatory hyperplastic growth which occurs on the mucosa along the borders of an ill fitting full or partial removable denture. If ulcerated, it can mimic oral squamous cell carcinoma. The treatment includes surgical removal of excess fibrous tissue and remodelling or reconstructing the denture suitably, ensuring better adaptability to the ridges. This case report describes a 55 year old male patient with characteristic clinical features of denture induced inflammatory hyperplasia.