Epulis

Abstract: 175 'epulides' were studied clinically and histologically. The lesions were histologically reclassified into three groups: granulomatous, fibromatous and giant cell lesions. The granulomatous group was four times and the giant cell group 1.5 times more frequent in females. It is suggested that the expression epulis should be abandoned as a microscopic designation for lesions in the oral mucosa, as it is only a non-specific topographico-clinical concept comprising histogenetically and histomorphologically differing lesions and therefore does not represent a uniform group. The suggested new terms for the three types of hyperplastic lesions are oral mucosal granulomatous hyperplasias (including such diagnostic terms as granulomatous gingivitis, gingivitis of pregnancy, granuloma gravidarium, pyogenic granuloma, epulis angiomatosa and epulis telangiectaticum), oral mucosal fibrous hyperplasias (including such diagnostic terms as fibrous epulis, epulis fissuratum, fibroepithelial lesions, denture injury tumor and peripheral odontogenic fibroma) and oral mucosal giant cell hyperplasia (including such diagnostic terms as peripheral giant cell granuloma and giant cell epulis).

Abstract: The skin and subcutaneous tissue and mucosae of the head and neck are areas of predilection for granular cell tumors. These often histogenetically enigmatic lesions have two principal clinicopathologic presentations: an infantile (congenital) epulis form of the gnathic gingiva and a noncongenital soft tissue and aerodigestive form. Recurrences of either form are largely attributable to marginal excision and, for all sites, approach 15%. A malignant granular cell tumor is recognized, but requires rigorous histologic confirmation.

Abstract: Aims: Based on our accumulated experience, the present study evaluates and discusses the indications, advantages and inconveniences of oral cavity epulis resection using the carbon dioxide laser (CO2) versus the Erbium:YAG laser (Er:YAG), diode laser and surgical scalpel. Material and methods: A retrospective study has been made of 120 patients involving the removal of 128 epulis lesions with the CO2 laser, Er:YAG laser, diode laser and surgical scalpel. Postoperative controls were carried out after 7, 15 and 30 days to evaluate healing and wound evolution, and after 3, 6 and 12 months to assess possible relapse. Results: Two groups were defined, based on the clinical and etiopathogenic characteristics of the excised lesions: gingival hyperplastic lesions (77 cases) and fibromatous hyperplasia (51 cases). The lower jaw was the most frequent location of gingival hyperplasia (51.9%). Fibrous hyperplasia was the most common histological diagnosis (49 cases; 63.6%). Percentage relapse following removal was 9.1%, of which 5 cases corresponded to fibrous hyperplasia. Only one malignancy was identified, corresponding to infiltrating squamous cell carcinoma. On the other hand, of the 51 treated cases of fibromatous hyperplasia, 58.8% were located in the upper jaw. These were histologically confirmed to be fibrous hyperplasia, with relapse in 19.6% of the cases. Conclusions: Although the different surgical techniques used for removal of epulis of the oral cavity are appropriate, we consider the CO2 laser to be the treatment of choice, since it offers a number of both intra- and postoperative advantages. On the other hand, all oral lesions require histological study to establish a firm diagnosis.