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Epulis Fissuratum Treatment & Management

  • Author: Diane Stern, DDS; Chief Editor: William D James, MD  more...
 
Updated: Mar 18, 2014
 

Surgical Care

Surgically excise the epulis fissuratum because even removal of the offending stimulus (ie, denture) will not result in complete resolution. In addition, correct the denture; otherwise, the lesion will recur. Either make a new denture or reline the old denture. The use of laser therapy is discussed in recent studies.[7, 8]

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Consultations

See the list below:

  • Oral and maxillofacial surgeon for excision
  • General dentist or prosthodontist for correction of the denture
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Contributor Information and Disclosures
Author

Diane Stern, DDS 

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Marjan Garmyn, MD, PhD Professor, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium; Chair and Adjunct Head, Department of Dermatology, University of Leuven, Belgium

Disclosure: Nothing to disclose.

References
  1. Bhattacharyya I. Case of the month. Epulis fissuratum. Todays FDA. 2008 Jul. 20(7):15, 17, 19. [Medline].

  2. Buchner A, Begleiter A, Hansen LS. The predominance of epulis fissuratum in females. Quintessence Int. 1984 Jul. 15(7):699-702. [Medline].

  3. Coelho CM, Zucoloto S, Lopes RA. Denture-induced fibrous inflammatory hyperplasia: a retrospective study in a school of dentistry. Int J Prosthodont. 2000 Mar-Apr. 13(2):148-51. [Medline].

  4. Keng SB, Loh HS. Clinical presentation of denture hyperplasia of oral tissues. Ann Acad Med Singapore. 1989 Sep. 18(5):537-40. [Medline].

  5. Ralph JP, Stenhouse D. Denture-induced hyperplasia of the oral soft tissues. Vestibular lesions, their characteristics and treatment. Br Dent J. 1972 Jan 18. 132(2):68-70. [Medline].

  6. Cutright DE. The histopathologic findings in 583 cases of epulis fissuratum. Oral Surg Oral Med Oral Pathol. 1974 Mar. 37(3):401-11. [Medline].

  7. Naveen Kumar J, Bhaskaran M. Denture-induced fibrous hyperplasia. Treatment with carbon dioxide laser and a two year follow-up. Indian J Dent Res. 2007 Jul-Sep. 18(3):135-7. [Medline].

  8. de Arruda Paes-Junior TJ, Cavalcanti SC, Nascimento DF, Saavedra Gde S, Kimpara ET, Borges AL, et al. CO(2) Laser Surgery and Prosthetic Management for the Treatment of Epulis Fissuratum. ISRN Dent. 2011. 2011:282361. [Medline]. [Full Text].

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An epulis fissuratum in the anterior part of the mandible shows a central groove where the denture flange rests. Note the inflammatory erythema. The surface of the lesion is usually smooth as shown in the image.
The mass in the posterior part of the maxillary vestibule is associated with a full denture; however, in this patient, the mass represented a squamous cell carcinoma. The surface is more granular in appearance, although this is not always the case.
A view of a whole mount of a tissue section taken from an epulis fissuratum shows that it is essentially a fibrous hyperplasia. The central groove can be observed, and, in this patient, papillary hyperplasia is present in some areas.
 
 
 
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