The fibrous epulis, a common tumor-like lesion of the gingiva, appears in the interdental papilla as a result of local irritation. Lesions are. For the purpose of clinical diagnosis, enlargements mentioned in this review are grossly are divided into isolated lesions (epulis) and regional or generalized. Fibroid mass in free gingiva, due to chronic gingival inflammation, pyogenic granuloma or other causes; May calcify or ossify. Terminology.

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An expeditious diagnosis can be made by a simple full blood count. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional or generalized gingival enlargement. Cherubism combined with epilepsy, mental retardation and gingival fibromatosis Ramon syndrome: East Afr Med J. The base was evacuated and the bone thoroughly curetted, and the healthy gingiva was sutured over it.

Orofacial soft tissues — Soft tissues around the mouth. The appearance of an epulis fissuratum microscopically is an overgrowth of cells from the fibrous connective tissue. Congenital granular cell tumor. Costello syndrome[ 25 flbrosa.

Epulis fissuratum

This condition occurs in association with denture wearing, and so those affected tend to be middle aged or older adults. Tumor arising from anterior maxillary alveolus. It can be associated with signs and symptoms of bone marrow failure, such as ecchymoses, night sweats, recent infections and lethargy. From Wikipedia, the free fiibrosa. Please review our privacy policy.

The histopathological findings are consistent with Tajima, 3 where the fibrous epulis was composed of proliferating fibroblasts and collagen fibers with a minimal degree of inflammatory cell infiltration and vascular dilatation.


Macrostomia, redundant skin of neck, hands and feet, nasal and perioral papillomas, enlargement within first years of life.

Radiographically, its radiolucency may sometimes lead to confusion with lateral periodontal cyst. The diagnosis can be confirmed based on histopathology, complete blood count and polymerase chain reaction[ 47 ].

Treatment usually includes complete excision of the lesion and thorough curettage of the area due to its origin from the periosteum and periodontal ligament cells to prevent recurrence. National Center for Biotechnology InformationU. Diagnosis epuli be made by a epuils family history of gingival enlargement. Peripheral giant cell granuloma They occur particularly in anterior region in young patients or in posterior mouth during mixed dentition phase and in adults.

Images hosted on PathOut server: This highly vascular lesion is characterized by purplish red-color and its tendency to bleed. Zimmerman-Laband syndrome[ 18 ]. Usual allergens known to be associated with this lesion could be, e. Tooth pain and numb chin as the initial presentation of systemic malignancy.

Meshwork of delicate blood vessels. In a typical bimaxillary protrusion case, the enlargement will fibdosa limited to palatal aspect of maxillary anteriors and labial aspect of mandibular anteriors. The most common presentation consists of pulmonary infiltration and hilar lymphadenopathy, dermal and ocular lesions[ 42 ], however oral involvement is uncommon.

Massive fibrous epulis—a case report of a year-old lesion

Accepted Aug Oral and maxillofacial medicine: Signs and symptoms related to gingival enlargement are seen within mo of initiation of drug intake. Hurler syndrome[ 26 ]. Painful crises on extremities and abdomen, angiokeratomas of skin, labial mucosa and buccal mucosa. A case of huge epulis osteoplastica.

It is thought to be due to alternate wetting and drying of the gingival surface. Oral Health Prev Dent. Drug influenced gingival overgrowth. Among commonly encountered drug induced gingival enlargement DIGOthose due to immunosuppressive agent like cyclosporine, appear more vascularized than phenytoin induced[ 17 ]. The overlying gingiva presents with no abnormal clinical features except the massive increase in size of the area; B: According to location, enlargements could be marginal, papillary or diffuse.


The diagnosis of these lesions is essential for their successful management and of the patient as a whole. This case demonstrates that the epulis can attain an unusually large size causing considerable facial deformity, an extreme and unusual presentation of a reactive condition.

Analysis of the surgical specimen. Treatment is by simple surgical removal of the lesion, and also by adjustment of the denture or provision of a new denture. Fibrotic Drug induced gingival enlargement: Nasopalatine duct Median mandibular Median palatal Traumatic bone Osteoma Osteomyelitis Osteonecrosis Bisphosphonate-associated Neuralgia-inducing cavitational osteonecrosis Osteoradionecrosis Osteoporotic bone marrow defect Paget’s disease of bone Periapical abscess Phoenix abscess Periapical periodontitis Stafne defect Torus mandibularis.

Signs and symptoms of these conditions must be strenuously trailed in these patients. Five-micrometer sections were obtained and submitted for routine hematoxylin—eosin staining. Eagle syndrome Hemifacial hypertrophy Facial hemiatrophy Oral manifestations of systemic disease.

Basal cell adenoma Canalicular adenoma Ductal papilloma Monomorphic adenoma Myoepithelioma Oncocytoma Papillary cystadenoma lymphomatosum Pleomorphic adenoma Sebaceous adenoma Malignant: Cowden syndrome[ 31 ].

Massive fibrous epulis—a case report of a 10-year-old lesion

Squamous cell papilloma Keratoacanthoma Malignant: It usually occurs in the mandibular labial sulcus. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be firbosa using reasonable medical judgment. They can be categorized based on their etiopathogenesis, location, size, extent, etc.