Bilateral tongue fibrous hyperplasia: A case report and literature review / Hiperplasia fibrosa bilateral de língua: relato de um caso e revisão daliteratura

Focal fibrous hyperplasia (FFH) is a pathology characterized by tissue enlargement as a result of increasing the number of inflammatory cells which receive chronic mechanical stimuli of low intensity that may affect gums, lip, palate, jugal mucosa and tongue.The aim of this article is to report a case of FFH on the lateral border on both sides of the tongue associated with the use of the Hyrax appliance in a hebiatric patient, whose chief complaint was chewing discomfort. This case was diagnosed clinically and by histopathology analysis and treated by surgical excision as well as the removal of Hyrax appliances. Follow-up care provided the recovery of the patient's quality of life.

La hiperplasia fibrosa focal (HFF) es una patología caracterizada por el aumento de tamaño de los tejidos como consecuencia del aumento del número de células inflamatorias que reciben estímulos mecánicos crónicos de baja intensidad que pueden afectar a encías, labio, paladar, mucosa yugal y lengua. El objetivo de este artículo es reportar un caso de FFH en el borde lateral a ambos lados de la lengua asociado al uso del aparato Hyrax en un paciente hebiátrico, cuyo principal motivo de consulta era la molestia masticatoria. Este caso fue diagnosticado clínicamente y por análisis histopatológico y tratado mediante escisión quirúrgica así como la retirada de los aparatos de Hyrax. La atención de seguimiento permitió la recuperación de la calidad de vida del paciente

Reactive Lesions Of Oral Cavity.

Oral mucosa is subjected constantly to external and internal stimuli that can give rise to reactive lesions. These lesions are non- neoplastic in nature. They manifest a spectrum of diseases that range from developmental, inflammatory, and reactive to neoplastic changes. Reactive lesions are typically gives response to chronic inflammation caused by various forms of low grade chronic irritations to the oral mucosa such as dental plaque and calculus, sharp edges of grossly carious teeth, faulty dental restorations, chronic biting habits, ill-fitting dental/oral appliances and food impactions. These lesions have a very similar appearance to benign neoplastic proliferations. This similarity is troublesome in differential diagnosis among them. Different types of localized reactive lesions of oral cavity are focal fibrous hyperplasia (FFH), pyogenic granuloma (PG), irritational fibroma, peripheral giant cell granuloma (PGCG), peripheral ossifying fibroma (POF), fibro-epithelial hyperplasia/polyp, inflammatory fibrous hyperplasia, and inflammatory gingival hyperplasia.

Laser cirúrgico no tratamento de hiperplasia fibrosa / Surgical laser on fibrous hyperplasia treatment

Objetivo: demonstrar, por meio de relato de caso clínico, a exérese de uma hiperplasia fibrosa inflamatória (HFI) com o uso de laser cirúrgico de diodo. Relato de caso: paciente leucoderma, gênero masculino, 48 anos, compareceu ao Ambulatório de Especialidades do SUS do Hospital São Vicente de Paulo, Passo Fundo/ RS, apresentando ausência do elemento dentário 46 e lesão nodular exofítica, pediculada, coloração rósea, superfície lisa em mucosa jugal medindo aproximadamente 2 cm, ocupando o espaço do elemento ausente, com histórico de 6 anos, sem queixa álgica no local. O tratamento proposto foi a remoção cirúrgica com laser de diodo, seguindo protocolo sugerido pelo fabricante. Sob anestesia infiltrativa local, realizou-se a excisão da lesão com incisão uniforme pela base. A peça cirúrgica foi fixada em formol 10% e encaminhada para exame anatomopatológico. O exame histopatológico apresentou como diagnóstico fibroma de irritação. Considerações finais: o uso de laser cirúrgico de diodo é um método seguro e eficaz, além de apresentar inúmeras vantagens quando comparado com a técnica convencional para excisões cirúrgicas de lesões de tecidos moles na cavidade oral. A remoção cirúrgica da HFI com pequena margem de segurança e remoção do fator etiológico constitui uma terapêutica satisfatória; a amostra deve sempre ser enviada para análise anatomopatológica, para confirmar o diagnóstico. O cirurgião-dentista deve ter conhecimento específico para operação e indicação do uso do laser cirúrgico.

Objective: to demonstrate through a clinical case report the excision of an inflammatory fibrous hyperplasia (IFH) with the use of surgical diode laser. Case report: male leucoderma patient, 48 years old, sought assistance on the Specialty Outpatient Clinic of SUS (Unified Health System) of the Hospital São Vicente de Paulo, in the city of Passo Fundo / RS - Brazil, lacking tooth 46 and with nodular exophytic lesion, pedunculated, with a pinkish color and smooth surface, on the buccal mucosa measuring approximately 2 cm and occupying the space of the missing element. The patient had a history of 6 years without pain complaint on site. The proposed treatment was surgical removal with diode laser, following manufacturer's suggested protocol. Under local infiltrative anesthesia, an excision of the lesion with uniform incision at the base was made. The surgical specimen was fixed in 10% formaldehyde and sent for pathological examination. Histopathological examination presented fibroma irritation as diagnosis. Final considerations: the use of surgical diode laser is a safe and effective method, and presents numerous advantages compared to the conventional technique for surgical excisions of soft tissue lesions in the oral cavity. Surgical removal of IFH with small safety margin, and removal of the etiologic factor is a satisfactory therapy. The sample should always be sent for pathological examination to confirm the diagnosis. The dentist must have specific knowledge to operate and recommend the use of surgical laser.

Peripheral ossifying fibroma: a clinical report / Fibroma osificante periférico: un reporte clínico

Localized growths are commonly seen on the gingiva. Many of these enlargements are considered to be reactive rather than neoplastic in nature. Clinically differentiating one from the other as a specific entity is often not possible. Histopathologic examination is needed in order to positively identify the lesion. The peripheral ossifying fibroma is one such lesion. We report in this study, the clinical report of a 20-yr-old male patient with a peripheral ossifying fibroma in the maxilla exhibiting significant size with the disease duration of 1 year. The signs of recurrence in spite of thorough excision and debridement exposed the need for further study of the causes of recurrence and possible modes to avoid the situation. Clinical, radiographical and histological characteristics are discussed and recommendations regarding treatment and follow-up are provided.

Aumentos de volumen localizados se observan con frecuencia en la encía. Muchos de estos crecimientos se consideran de tipo reaccional más que de naturaleza neoplásica. Clínicamente diferenciar uno del otro como una entidad específica no siempre es posible. El examen histopatológico es necesario con el fin de identificar positivamente a la lesión. El fibroma osificante periférico es una de estas lesiones. Se presenta en este estudio, el informe clínico de un paciente de sexo masculino de 20 años de edad con un fibroma osificante periférico en el maxilar de un tamaño significativo con 1 año de duración de la lesión. Los signos de recurrencia a pesar de la escisión completa y desbridamiento expusieron la necesidad de estudiar más a fondo las causas de la recurrencia y los posibles modos de evitar la situación. Las características clínicas, radiográficas e histológicas son discutidas junto a recomendaciones sobre el tratamiento y seguimiento.

Laser Excision of A Giant Cell Fibroma - Report of A Case And Review of Literature.

Giant cell fibroma is a non-neoplastic lesion of fibrous connective tissue origin considered to be a variant of fibroma. It differs significantly from routine fibromas in that its stroma contains very large stellate fibroblasts, making it to be known as a separate entity. The purpose of this article is to report a case of a gaint cell fibroma in a 35-year-old male patient and briefly emphasize on the differential diagnosis of this lesion. Though it is customary to manage giant cell fibroma with routine excisional biopsy, our case report highlighted the use of a diode laser as an alternate safe and reliable technique to remove the lesion without any postoperative discomfort and minimize the patient’s esthetic concerns.

Consideraciones actuales en hiperplasia fibrosa inflamatoria / Current considerations in inflammatory fibrous hyperplasia

El objetivo de esta investigación es evaluar los aspectos clínicos, histológicos y las posibilidades de tratamiento de la hiperplasia fibrosa inflamatoria (HFI). Esta lesión se origina frecuentemente a partir de prótesis totales o parcial mal adaptadas, las cuales generan un traumatismo crónico de baja intensidad. Se han descrito lesiones en mandíbula y maxila, no existiendo predilección por ninguna de las arcadas dentales. Lesiones pequeñas pueden ser tratadas de manera conservadora, con remoción del agente causal o mediante atrofia por presión con nuevas prótesis, mientras que lesiones extensas y de larga evolución necesitarán de escisión quirúrgica. Si el tratamiento quirúrgico es considerado, éste debe incluir la remoción total de la lesión, usando diversas técnicas como bisturí “frío” (lámina), láser o electrocirugía.La remoción quirúrgica es necesaria, pues restaura el contorno normal del tejido y la adaptación protética. Algunos autores han reportado alteraciones displásicas en la HFI, pero la posibilidad de que ésta sufra una transformación maligna aún es muy discutida.

The objective of this research is an evaluate of clinical and histologic aspects of fibrous inflammatory hyperplasia and the possibilities of its treatment. This lesion is frequently originated for using total or partial prosthesis which are inadequate adapted generating a chronic traumatism of low intensity. Clinical cases in jaw and maxila have been reported, not existing predilection for any dental arches. Small lesions can be treated by the conservative way that means removing the causal agent or atrophying by putting pressure with a new prosthesis, whereas extensive lesions of large evolution need surgical excision. If the surgical treatment is considered, this should include the total removal of the lesion, using varieties of techniques such as “cold” scalpel, laser or electrosurgical techniques. The surgical removal is necessary because recover the normal contour of tissue and the prosthetic adaptation. reports exist about dysplasic alterations related to fibrous inflammatory hyperplasia, but the possibility of a malignant transformation is actually controversial.

Denture-related hyperplasia: a clinical study of a turkish population group

Inflammatory fibrous hyperplasia (epulis fissuratum) (IFH) and inflammatory papillary hyperplasia (IPH) are oral mucosal diseases caused by ill-fitting denture wearing. A study was carried out on a group of Turkish people consisted of 131 female and 39 male complete denture wearers (n= 170) distributed in two age groups (30-60 and 60-80 years old). The analysis of data collected from patients showed that while the incidence of IFH was higher in women than in men, the incidence of IPH was similar. Most lesions were found in the 30-60 year-old group. The incidence of lesions increased as the denture wearing period increased. Soft tissue growth was the main complaint of the patients with IFH and IPH. In the maxilla, the incidence of IFH was higher than IPH. There was also a significant difference between the distribution of the lesion types in the jaws. There were a larger number of lesions in the maxilla compared to the mandible and most IFH lesions were located in the anterior region of the jaws.

A hiperplasia fibrosa inflamatória (epulis fissuratum) (HFI) e a hiperplasia papilar inflamatória (HPI) são doenças da mucosa causadas por próteses mal-ajustadas. Foi feito um estudo num grupo de pessoas, na Turquia, composto por 131 mulheres e 39 homens (n=170) usuários de próteses totais. O grupo foi subdividido em duas faixas etárias (30 a 60 e 60 a 80 anos). A análise dos dados coletados dos pacientes mostrou que a incidência de HFI foi mais alta entre as mulheres, ao passo que a incidência de HPI foi similar em ambos os sexos. A maioria das lesões foi encontrada no grupo indivíduos de 30 a 60 anos. A incidência das lesões aumentou com o tempo de uso da prótese. A queixa principal dos pacientes com HFI e HPI foi o aparecimento de tecidos moles. A incidência de HFI foi maior do que HPI, na maxila. Houve também diferença significativa de distribuição dos tipos de lesão nos maxilares. Houve maior número de lesões na maxila, em comparação com a mandíbula e a maioria das lesões HFI estava localizada na parte anterior dos maxilares.

Management of fibrous hyperplasia in oral mucosa / 대한치과보존학회지

There are a number of situations where the oral mucosa can be sucked or pressed to produce relatively banal but clinical distinctive changes. The labial and buccal mucosa and tongue may develop protuberances in areas where a tooth is missing or extra space is present. The mucosa is pressed and sucked into these spaces, thus leading to the development of a fibrous hyperplasia. This case report describes the management of fibrous hyperplasia in oral mucosa. Fibrous hyperplasia can be formed by habitual pressure or suction in oral mucosa. Treatment of fibrous hyperplasia consists of simple excision and, if feasible, elimination of the cause. And habit control is a important factor for preventing recurrence.

Hiperplasia fibrosa inflamatoria por cámara de succión: tratamiento quirúrgico: relato de caso clínico / Inflamatory fibrous hyperplasia caused by suction chamber surgical treatment: case report

La hiperplasia fibrosa inflamatoria por cámara de succión es una lesión reacional asociada a la cámara de succión, artefacto antiguamente utilizado para aumentar la retención estabilidad de la prótesis total superior. El objetivo de este trabajo es relatar un caso de hiperplasia fibrosa inflamatoria por cámara de succión en una mujer, 76 años, cuya opción ha sido la remoción quirugica

Inflammatory fibrous hyperplasia caused by upper dentures with suction-chamber, an old-fashioned maneuver to achieve retention and stability of upper dentures. The aim of this study is to report a case of inflammatory fibrous hyperplasia caused by upper dentures on a female patient, 76 years old, that was treated by surgery