Epulis fissuratum
Encyclopedia
Epulis fissuratum is an oral pathologic condition that appears in the mouth
as an overgrowth
of fibrous connective tissue
. Also referred to less commonly as inflammatory fibrous hyperplasia, denture epulis, and denture induced fibrous hyperplasia, it is associated with the edges of a denture that does not fit well. The word, "epulis", can be used to describe any gingiva
l tumor, but it is widely used in association with this specific condition.
. Usually, the edge of the denture rests in between two of the folds. The excess tissue is firm and fibrous, and ulcerations may be present. The size of the affected tissue varies widely, since almost the entire length of tissue around a denture can be affected. More commonly found in women, it can appear in either the mandible or maxilla
(upper jaw) but is more commonly found in the anterior portions of the mouth rather than in the posterior. Women during pregnancy can also present with an epulis, which will resolve after birth. Fibroepithelial polyps, pedunculated lesions of the palate beneath an upper denture, are associated with this condition. An epulis fissuratum in a patient without dentures can also be diagnostic of Crohn's disease
.
Epulis fissuratum can also appear around dental implants. In this photo, taken after antibiotic and periodontal therapy, it occurred because the implant denture clasp had broken and the patient exhibited poor oral hygiene.
The appearance of an epulis fissuratum microscopically is an overgrowth of cells
from the fibrous connective tissue. The epithelial cells
are usually hyperkeratotic and irregular, hyperplastic rete ridges are often seen.
Treatment consists of surgical
removal with the fixing of a denture in a process called a "reline" or with making a new denture.
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
as an overgrowth
Hyperplasia
Hyperplasia means increase in number of cells/proliferation of cells. It may result in the gross enlargement of an organ and the term is sometimes mixed with benign neoplasia/ benign tumor....
of fibrous connective tissue
Connective tissue
"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...
. Also referred to less commonly as inflammatory fibrous hyperplasia, denture epulis, and denture induced fibrous hyperplasia, it is associated with the edges of a denture that does not fit well. The word, "epulis", can be used to describe any gingiva
Gingiva
The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
l tumor, but it is widely used in association with this specific condition.
Causes
Epulis fissuratum appears as a single or multiple fold of tissue that grown in excess around the alveolar vestibule, which is the area where the gums meet the inner cheekCheek
Cheeks constitute the area of the face below the eyes and between the nose and the left or right ear. They may also be referred to as jowls. "Buccal" means relating to the cheek. In humans, the region is innervated by the buccal nerve...
. Usually, the edge of the denture rests in between two of the folds. The excess tissue is firm and fibrous, and ulcerations may be present. The size of the affected tissue varies widely, since almost the entire length of tissue around a denture can be affected. More commonly found in women, it can appear in either the mandible or maxilla
Maxilla
The maxilla is a fusion of two bones along the palatal fissure that form the upper jaw. This is similar to the mandible , which is also a fusion of two halves at the mental symphysis. Sometimes The maxilla (plural: maxillae) is a fusion of two bones along the palatal fissure that form the upper...
(upper jaw) but is more commonly found in the anterior portions of the mouth rather than in the posterior. Women during pregnancy can also present with an epulis, which will resolve after birth. Fibroepithelial polyps, pedunculated lesions of the palate beneath an upper denture, are associated with this condition. An epulis fissuratum in a patient without dentures can also be diagnostic of Crohn's disease
Crohn's disease
Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
.
Epulis fissuratum can also appear around dental implants. In this photo, taken after antibiotic and periodontal therapy, it occurred because the implant denture clasp had broken and the patient exhibited poor oral hygiene.
The appearance of an epulis fissuratum microscopically is an overgrowth of cells
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....
from the fibrous connective tissue. The epithelial cells
Epithelium
Epithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the cavities and surfaces of structures throughout the body, and also form many glands. Functions of epithelial cells include secretion, selective...
are usually hyperkeratotic and irregular, hyperplastic rete ridges are often seen.
Treatment consists of surgical
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
removal with the fixing of a denture in a process called a "reline" or with making a new denture.