Epulis: Signs, Causes, And Treatment
Describe about etiology, clinical features and treatment of epulis.
Answer. Epulis means upon gum.
It refers to solid swelling situated on the gum.
Localized enlargement of gingiva is mainly known asepulis.
It arises from alveolar margin of jaw.
Epulis can originate from the bone, periosteum or the mucous membrane.
“Causes Of Epulis In Gums”
Types Of Epulis
Granulomatous epulis/Pyogenic Granuloma
- It is also called false epulis or pyogenic epulis.
- Precipitating factors are: Carious tooth, dentures, poor oral hygiene.
Epulis Clinical features
- The important point is that it does not contain pus while its name is pyogenic epulis.
- Pregnancy epulis refer to this variety.
- It is a mass of granulation tissue around the carious tooth on the gum.
- It is a soft to fim flshy mass and bleed on touch.
“Symptoms Of Epulis”
Epulis Treatment
- Extraction of associated carious tooth.
- Removal of local irritation as ill-fitng denture.
- Excision of granulation tissue.
- Pregnancy epulis regress spontaneously after delivery.
Epulis Fibrous epulis
It is the most common type of epulis.
Epulis Clinical Features
- Arises from periosteum at the neck of teeth.
- It is localized inflmmatory hyperplasia of gum.
- It occurs in response to local irritation.
- It is composed of firous tissue and blood vessels.
- It is a fim polypoidal mass, slowly growingand non-tender.
Epulis Treatment
Excision of growth and removal of local irritants.
Giant Cell epulis/Myeloid epulis
Giant Cell epulis Clinical Features
- It is less common, purple and pedunculated tumor.
- It is an “osteoclastoma” arising in the jaw.
- It present as hyperemic vascular edematous, soft to fim gums with indurated underlying mass due to expansion of the bone.
- It may ulcerate and result in hemorrhage.
- Multinucleated giant cells are found in histology.
- It is more rapidly growing tumor than any other epulis.
“Best Ways To Prevent Epulis”
Giant Cell epulis Treatment
- Small tumors are treated by curettge.
- Large tumors are treated by radical excision.
Carcinomatous epulis
Carcinomatous Clinical Features
- This is an “epithelioma” arising from mucous membrane of alveolar margin.
- It presents as a non-healing, painless ulcer.
- It slowly infitrates the bone.
- Hard regional lymph nodes are due to metastasis.
Carcinomatous Treatment
Treated by wide excision, which include removal of segment of the bone.
Congenital epulis
- This is a benign condition seen in a newborn arising from the gum pads.
- This is the variant of granular cell myeloblastoma originating from the gums.
- This is common in girls and more common in upper jaw mainly in canine or premolar area.
- Congetinal epulis is a well localized swelling from the gum which bleeds on touch.
- Excision of congenital epulis should be done.
“Risk Factors For Developing Epulis”
Myelomatous epulis
- This occurs mainly in leukemic patients.
- Treatment of leukemia resolves this condition.
Giant Cell epulis
This is the osteoclastoma causing ulceration and hemorrhage of gingiva.
Fibrosarcomatous epulis
It is the firosarcoma arising from the firous tissue of gums.
Carcinomatous epulis
Squamous cell carcinoma of alveolus and gingiva, present localized, hard, indurated, swelling with ulceration.
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