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Abstract Background To analyze the clinicopathological features of different histological subtypes of epulis, and evaluate the risk factors associated with recurrence. Materials and methods A retrospective study including 2971 patients was performed. The patients’ sex, age, location, size, histological subtypes, recurrence information, oral hygiene habits, periodontitis symptoms and smoking history were retrieved from the patient medical records and follow-up information. Results Among the 2971 cases, focal fibrous hyperplasia (FFH) was the most common lesion (60.92%), followed by peripheral ossifying fibroma (POF) (29.32%), pyogenic granuloma (PG) (8.08%) and peripheral giant cell granuloma (PGCG) (1.68%). The peak incidence of epulis was in the third and fourth decade of life, with a mean age of 45.55 years. Female predominance was found in all types of lesions with a female to male ratio of 1.71:1. PG had the highest recurrence rate (17.18%), followed by POF (12.98%), FFH (9.55%) and PGCG (8.82%). Histological subtypes were significantly correlated with the recurrence of epulis (P = 0.013). Regular supportive periodontal therapy (P = 0.050) had a negative correlation with recurrence, whereas symptoms of periodontitis (P

Gingival overgrowth is one of the most undesirable consequences that often lead to impaired esthetics and masticatory functions, compromised oral hygiene maintenance often requiring surgical excision of the excessive tissue. Gingival overgrowth belongs to a common group of lesions designated as focal reactive overgrowths. These growths are reactive in nature. A definitive diagnosis will then enable an appropriate management strategy. Peripheral giant-cell granuloma (PGCG) is a reactive focal overgrowth, ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. It is widely considered to originate from the cells of the periodontal ligament, occurring as a response to irritants such as dental calculus, plaque, microorganisms, dental appliances, and restorations. The purpose of this article is to report the clinical, histopathological features and treatment of a case with PGCG arising from mandibular posterior alveolus in a 34-year-old female. The overgrowth was well defined along with the bone defect, involving the buccal aspect of the mandibular gingiva. The tooth was endodontically treated, the lesion was completely excised, and the osseous defect was filled with regenerative material. The 12-month follow-up radiograph revealed successful healing with no more recurrence.

Epulis is a type of proliferative gingival disease, and usually occurs in the lip or buccal gingiva near the papilla canines and premolars. Females are more prone to epulis than male counterparts. The resection of large epulis is often accompanied by keratinized gingival narrowing and the exposure of bone and root surface, etc. In this article, a case of epulis admitted to the department of periodontal mucosa was reported. During surgical resection of epulis, coronally repositioned flap was simultaneously utilized to cover the exposed bone and root surface by combining the basic principle of mucogingival surgery. This technique can prevent the occurrence of postoperative complications to the largest extent, such as infection, bone absorption, root exposure and root dentin hypersensitivity, achieving excellent aesthetic repair of the soft tissues. Regarding the diagnosis and treatment of this case, the coronally repositioned flap has the advantages of simple operation and avoids the second surgical area.

Background: To analyze the clinicopathological features of different histological subtypes of epulis, and evaluate the risk factors associated with recurrence. Materials and methods: A retrospective study including 2971 patients was performed. The patients' sex, age, location, size, histological subtypes, recurrence information, oral hygiene habits, periodontitis symptoms and smoking history were retrieved from the patient medical records and follow-up information. Results: Among the 2971 cases, focal fibrous hyperplasia (FFH) was the most common lesion (60.92%), followed by peripheral ossifying fibroma (POF) (29.32%), pyogenic granuloma (PG) (8.08%) and peripheral giant cell granuloma (PGCG) (1.68%). The peak incidence of epulis was in the third and fourth decade of life, with a mean age of 45.55 years. Female predominance was found in all types of lesions with a female to male ratio of 1.71:1. PG had the highest recurrence rate (17.18%), followed by POF (12.98%), FFH (9.55%) and PGCG (8.82%). Histological subtypes were significantly correlated with the recurrence of epulis (P = 0.013). Regular supportive periodontal therapy (P = 0.050) had a negative correlation with recurrence, whereas symptoms of periodontitis (P < 0.001) had a positive correlation with the recurrence of epulis. Conclusions: Controlling the periodontal inflammation and regular supportive periodontal therapy might help reduce the recurrence of epulis. [ABSTRACT FROM AUTHOR]

The epulis is a tumor caused by the chronic irritation or trauma of restorations, of any sharp and overhanging edges of crowns/bridges, or mobile prostheses, found mostly in the buccal side of the gingiva and interdental papillae. It appears like a sessile lesion with a smooth or ulcerated surface. The main scope of this study is to show some clinical and histological features of epulides from patients suffering or not from diabetes mellitus. The study is a series of 15 cases of patients with and without diabetes melitus. The diagnosis of epulis was made by an oral medicine specialist based on clinical and histopathological features. In most cases, the epulides were located on the buccal side of the gingiva and near an irritating factor (dental crowns or bridges). The most frequent histopathological diagnosis was the fibrous pattern with abundant chronic perivascular and interstitial lymphoplasmacytic infiltrate covered by acanthotic non-keratinized stratified squamous epithelium. [ABSTRACT FROM AUTHOR]

Gingival overgrowth is one of the most undesirable consequences that often lead to impaired esthetics and masticatory functions, compromised oral hygiene maintenance often requiring surgical excision of the excessive tissue. Gingival overgrowth belongs to a common group of lesions designated as focal reactive overgrowths. These growths are reactive in nature. A definitive diagnosis will then enable an appropriate management strategy. Peripheral giant-cell granuloma (PGCG) is a reactive focal overgrowth, ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. It is widely considered to originate from the cells of the periodontal ligament, occurring as a response to irritants such as dental calculus, plaque, microorganisms, dental appliances, and restorations. The purpose of this article is to report the clinical, histopathological features and treatment of a case with PGCG arising from mandibular posterior alveolus in a 34-year-old female. The overgrowth was well defined along with the bone defect, involving the buccal aspect of the mandibular gingiva. The tooth was endodontically treated, the lesion was completely excised, and the osseous defect was filled with regenerative material. The 12-month follow-up radiograph revealed successful healing with no more recurrence. [ABSTRACT FROM AUTHOR]

Abstract Background Fibrous sclerosing tumours and hypertrophic lesions in IgG4-related disease (IgG4-RD) are formed in various organs throughout the body, but disease in the oral region is not included among individual organ manifestations. We report a case of ossifying fibrous epulis that developed from the gingiva, as an instance of IgG4-RD. Case presentation A 60-year-old Japanese man visited the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, with a chief complaint of swelling of the left mandibular gingiva. A 65 mm × 45 mm pedunculated tumour was observed. The bilateral submandibular lymph nodes were enlarged. The intraoperative pathological diagnosis of the enlarged cervical lymph nodes was inflammation. Based on this diagnosis, surgical excision was limited to the intraoral tumour, which was subsequently pathologically diagnosed as ossifying fibrous epulis. Histopathologically, the ossifying fibrous epulis exhibited increased levels of fibroblasts and collagen fibres, as well as infiltration by numerous plasma cells. The IgG4/IgG cell ratio was > 40%. Serologic analysis revealed hyper-IgG4-emia (> 135 mg/dL). The patient met the comprehensive clinical diagnosis criteria and the American College of Rheumatology and European League Against Rheumatism classification criteria for IgG4-RD. Based on these criteria, we diagnosed the ossifying fibrous epulis in our patient as an IgG4-related disease. A pathological diagnosis of IgG4-related lymphadenopathy was established for the cervical lymph nodes. Concomitant clinical findings were consistent with type II IgG4-related lymphadenopathy. Conclusions A routine serological test may be needed in cases with marked fibrous changes (such as epulis) in the oral cavity and plasma cells, accompanied by tumour formation, to determine the possibility of individual-organ manifestations of IgG4-related disease.

“Epulis” is a widely used term to describe a localized gingival enlargement. However, a wide range of neoformations might present as localized, slow-growing, asymptomatic gingival masses. A systematic review was conducted to outline the pathological entities that were provisionally dignosed as “epulis” and whose final diagnosis was made after microscopic examination. An electronic search of PubMed, Google Scholar and Scopus databases from January 2000 to February 2021 was performed. An initial search of the databases identified a total of 864 documents, and after a careful process of screening and selection, 14 studies were included in this systematic review and processed for data extraction. The results show that histological examination, sometimes combined with immunohistochemistry, might reveal a wide spectrum of lesions, including hamartomatous lesions, non-neoplastic lesions, benign and malign neoplasms and metastases from distant cancers.

Introduction. Epulis is a change in gingival tissue that occurs under the influence of chronic irritation. Histologically, there are several different types of epulis. Fibrous epulis is benign tumor of gingiva that most often occurs in interdental papilla area as a result of local irritation (inadequate restorative fillings, carious teeth, subgingival deposits or the combination of them). The aim of this paper is to present a clinical case of fibrous epulis. Case report. A 25-year-old girl reported to the Specialist Center for Dentistry in Foca. Clinical examination revealed a gingival tissue enlargement in the area of the upper jaw central incisors with speech and chewing function disturbances. Intraoral examination revealed a change above the level of gingiva, reddish-pink in color with smooth surface texture and soft consistency. The size of the change was 1 x 1.5 cm. It was connected to the interdental gingiva between teeth 12 and 21 by a narrower base. Clinically, a significant amount of soft and hard dental deposits surrounded the remaining teeth. Remaining gingiva was swollen, red, bleeding on provocation. The anamnesis did not confirm the presence of other acute and chronic diseases. The patient was not pregnant. She was informed about clinical condition assessment, as well as possible therapeutic procedures. Our patient was treated with non-surgical periodontal therapy and surgical excision of the enlargement. After histopathological examination of the removed tissue, the diagnosis was made: “Fibrous epulis cum ulceration”. Conclusion. Clinical examination is insufficient for definite diagnosis. Therefore, a histopathological examination of the tissue is mandatory for fibrous epulis definite diagnosis. Treatment of choice is surgical excision of the enlargement and removal of predisposing factors to avoid recurrence.

We report three varied presentations of peripheral giant cell granuloma and provide an up-to-date summary on the diagnosis, treatment and prognosis of this everyday swelling, including lessons learned.

Background: Fibrous sclerosing tumours and hypertrophic lesions in IgG4-related disease (IgG4-RD) are formed in various organs throughout the body, but disease in the oral region is not included among individual organ manifestations. We report a case of ossifying fibrous epulis that developed from the gingiva, as an instance of IgG4-RD. Case presentation: A 60-year-old Japanese man visited the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, with a chief complaint of swelling of the left mandibular gingiva. A 65 mm × 45 mm pedunculated tumour was observed. The bilateral submandibular lymph nodes were enlarged. The intraoperative pathological diagnosis of the enlarged cervical lymph nodes was inflammation. Based on this diagnosis, surgical excision was limited to the intraoral tumour, which was subsequently pathologically diagnosed as ossifying fibrous epulis. Histopathologically, the ossifying fibrous epulis exhibited increased levels of fibroblasts and collagen fibres, as well as infiltration by numerous plasma cells. The IgG4/IgG cell ratio was > 40%. Serologic analysis revealed hyper-IgG4-emia (> 135 mg/dL). The patient met the comprehensive clinical diagnosis criteria and the American College of Rheumatology and European League Against Rheumatism classification criteria for IgG4-RD. Based on these criteria, we diagnosed the ossifying fibrous epulis in our patient as an IgG4-related disease. A pathological diagnosis of IgG4-related lymphadenopathy was established for the cervical lymph nodes. Concomitant clinical findings were consistent with type II IgG4-related lymphadenopathy. Conclusions: A routine serological test may be needed in cases with marked fibrous changes (such as epulis) in the oral cavity and plasma cells, accompanied by tumour formation, to determine the possibility of individual-organ manifestations of IgG4-related disease. [ABSTRACT FROM AUTHOR]

L´épulis est une pseudotumeur bénigne hyperplasique des gencives fréquente, elle répondra à deux critères qui font l´unanimité: topographique: la localisation de l´épulis au niveau du collet d´une ou de deux dents contiguës; bénignité: l´épulis est en effet une tumeur qui ne récidive pas après exérèse complète, ne donne pas de métastases, ni d´envahissement ganglionnaire. Le cas d´un patient de 70 ans nous est rapporté. Celui-ci est adressé par son dentiste traitant pour réaliser une édentation mandibulaire totale avant confection d´une prothèse complète et avis concernant une lésion suspecte évoluant depuis 3 ans, indurée, saignant spontanément au contact et associée à une lésion ostéolytique homogène en regard de la dent 47. Le patient présente comme seul antécédent notable une néoplasie prostatique traitée par chirurgie seule en 2012, sans intoxication alcoolo-tabagique. La symptomatologie est fruste avec seulement de faibles douleurs intermittentes calmées par la prise d´antalgiques. Le signe de Vincent est négatif. L´aspect radiologique initial avec une ostéolyse d´aspect homogène centrée sur l´apex dentaire de la deuxième molaire droite avec un liseré radio-opaque et respectant le canal du nerf alvéolaire nous confortait dans l´hypothèse de lésion bénigne. L´examen anatomopathologique posait le diagnostic de certitude à savoir, un épulis inflammatoire. Un contrôle post-opératoire clinique et radiologique est réalisé à quinze jours et montre une bonne cicatrisation accompagnée d´une absence de symptomatologie algique et infectieuse. Devant la présentation clinico-radiologique, les diagnostics différentiels retenus étaient le carcinome épidermoïde, une métastase de l´adénocarcinome prostatique, un épulis inflammatoire ou encore un lymphome.

The pure pregnancy epulis is mostly vascular, and generally shrinks or disappears with the drop in estrogen levels following delivery. However, the fibrous epulis or granulomatous epulis may enlarge rapidly in the early stages of pregnancy, necessitating surgical resection after pregnancy. This report described a 25-yearold patient with a post-term pregnancy. She had a lump on the buccal side of left mandibular molar region that was associated with intermittent hemorrhage and eating difficulty. Since the patient feared the conventional surgery, the 980-nm diode laser excision was performed to remove the epulis two weeks after delivery, with the involved teeth preserved. The new technique of 980-nm diode semiconductor laser may be a potential good option to treat pregnancy epulis, with less discomfort and involved teeth preserved. [ABSTRACT FROM AUTHOR]

Congenital granular cell epulis (CGCE) is an uncommon lesion of unclear pathogenesis. It occurs predominantly in female newborns with a predilection site of the maxillary alveolar ridge. The mass enlarges prenatally but the growth arrests after birth. Histologically, CGCE is characterized by a proliferation of polygonal cells with eosinophilic, granular cytoplasm and eccentric, bland-appearing nuclei. It closely resembles adult granular cell tumor (GCT) microscopically and S-100 immunostain is often helpful in distinguishing the two (S-100-positive in GCT and S-100-negative in CGCE). Clinically, the lesion should also be distinguished from entities such as infantile myofibroma, rhabdomyoma, melanotic neuroectodermal tumor of infancy, peripheral odontogenic fibroma, and neurofibroma. CGCE demonstrates an excellent prognosis and has not been associated with any syndromes/genetic defects or malignant transformation. Clinicians and pathologists should be familiar with this rare entity and its differential diagnosis for accurate diagnosis and management. [ABSTRACT FROM AUTHOR]

Congenital granular cell tumor of the newborn is a benign, relatively innocuous hamartomatous lesion arising from the alveolar ridge. Large lesions often warrant prompt surgical removal owing to the associated difficulty in breastfeeding and respiration of the infant. However, for medium-sized lesions, another approach could be observed for spontaneous regression. The present case report highlights the use of a combination approach for management of tumor in a 2-day-old female child presenting with a large protruding mass from the mouth associated with difficulty in breastfeeding. A combination of observation for regression in size followed by electrosurgical removal of the tumor was done. The infant was followed up regularly over a long period of 3 years to assess any adverse effects of surgical intervention on the maxillary primary anterior dentition of which none were recorded.

Aim: To evaluate the clinicopathological features including variations of fifty oral pyogenic granuloma cases reported to Department of Oral medicine and Radiology, Dhule. Materials and Methods: A retrospective review for the fifty cases reported as PG was performed, and data for the following parameters were recorded: age, gender, history of trauma or any other etiology, site and clinical presentation, variation in histology, treatment mode, and recurrence. Results: PG was most commonly seen in the second (36%) and third (46%) decade, with a female preponderance (male: female 1:4). Gingiva was more commonly involved (90%) followed by the lip (6%) and ventral surface of the tongue (4%). Classic clinical presentation of PG exhibited as a sessile or pedunculated, firm or soft, erythematous, exophytic, and/or painful papule or nodule with a smooth or lobulated surface that bleeds easily. Conclusion: Although it is a benign lesion which is commonly encountered and excised in dental practice, it is important to recognize these variants to avoid misdiagnosis, it is always wise to subject it to histopathological confirmation owing to its close clinical resemblance to neoplastic condition.

Introduction: Epulis fissuratum is one of the important denture-related mucosal lesions that occurs around the borders of an ill-fitting denture. The purpose of this study was to analyze the cases of epulis fissuratum admitted in the department of oral medicine, Kerman Dental School in relation to the demographic, denture-related and clinical findings. Materials &Methods: Medical files of all patients referred to the Department of Oral Medicine and Oral Pathology, Kerman Dental School, Iran from 1999 to 2014 were reviewed and 58 cases with the diagnosis of epulis fissuratum with complete and acceptable data were illustrated. Results: The frequency of epulis fissuratum was 2.9 % of the total number of pathologies. The disorder had been occurred predominantly in the sixth decade of life (41.4%) and more often among females (79.3%). The frequency of epulis fissuratum was higher for a length of denture use of more than 10 years. Patients reported pain associated with the lesion (70.6%). Conclusion: The knowledge of some facts, especially the quality of dentures and level of denture hygiene in patients with epulis fissuratum supports the importance of the prevention of the lesion, hence the dentists should instruct their patients who have worn dentures how to prevent this lesion.

Congenital granular cell epulis (CGCE) is a rare benign lesion of the newborn. It was first described in 1871 by Neumann. The exact etiology of the condition still remains unknown. There is marked female preponderance 10:1. The lesion is usually solitary, but multiple lesions are seen in 10% of cases. They arise from the gingival mucosa of the maxillary or mandibular alveolar ridge. Depending on the size of the lesion it can be asymptomatic or can cause feeding or respiratory problems. Imaging studies can help in the prenatal diagnosis of the lesion as early as 26 weeks of pregnancy. Spontaneous regression can occur, but surgery is the treatment of choice in symptomatic patients. CGCE is important as it has to be differentiated from the other aggressive lesions of early life. We report a case of 1 day old female neonate with intraoral lesion. The histopathology of the excised specimen helped in the diagnosis.

Objective To evaluate the effect of palatal free gingiva in anterior maxillary defect restoration after epu⁃ lis resection. Methods 22 cases were included in this study. Palatal free gingival flap was prepared to restore anterior maxillary defect after epulis resection. Clinical effect was evaluated according to gingival margin, gingival papilla index and modified sulcus bleeding index. Results Satisfactory clinical effect was achieved in all 22 cases, with adequate height, thickness, fullness and texture. Conclusion Palatal free gingival flap was clinically effective in anterior maxil⁃ lary defect treatment after epulis resection, with satisfactory aesthetic clinical effect.

A 35-year-old patient presented with a painless, broad-based exophytic lesion in the buccal interdental region between teeth 13 and 14. Despite oral hygiene efforts the lesion persisted for around one year. Radiology excluded bone involvement, and histopathology after excision confirmed a fibromatous epulis, which is characterized by collagen-rich connective tissue. There was no recurrence within one-year follow-up. Surgical removal proved to be efficient., (Copyright 2024 SWISS DENTAL JOURNAL SSO – Science and Clinical Topics. License: This work is licensed under a Creative Commons Attribution 4.0 International License.)

Lesions of the gingivae are amongst the commonest lesions seen in patients and the vast majority are reactive hyperplasias, related to a number of chronic irritant stimuli. However, there are a number of entities that have a predilection for the gingivae, which are much less common in other parts of the oral cavity. The purpose of this paper is to discuss the clinical and histological differential diagnoses when presented with a lump on the gingivae, including the approach to diagnosis and diagnostic pitfalls. [ABSTRACT FROM AUTHOR]

The peripheral giant cell granuloma (PGCG) is a relatively common tumor-like growth of the oral cavity. It is also known as giant cell epulis. PGCG is an oral, nonneoplastic, tumor-like growth that occurs exclusively on the gingiva and the alveolar mucosa. It affects both sexes, with a slight predilection for females, especially after puberty. It is not a true neoplasm but rather benign hyperplasic lesion. It is probably caused by local irritation or trauma which resulted in gingival or mucosal hemorrhage.

Epulis is a common hyperplastic benign pseudotumor of the gums. It meets two criteria which are unanimous: topographical with the epulis affecting the neck of one or two adjacent teeth; benign, because the epulis is a tumor that does not recur after complete excision, does not produce metastases or lymph node involvement. We here report the case of a 70-year-old patient who was referred by his dentist to perform total mandibular edentation before making complete denture prosthesis and with a diagnosis of suspicious indurated lesion that had progressed for 3 years, spontaneously bleeding on contact and associated with homogeneous osteolytic lesion in relation to tooth 47. The patient had only a history of prostatic neoplasia which wasn't associated with alcohol-tobacco poisoning and treated by surgery in 2012. Symptoms were vague; only low intermittent pain relieved with analgesic use. Vincent's sign was negative. Initial radiological appearance was characterized by homogeneous osteolysis centered to the apex of the right second molar with radiopaque border, respecting the alveolar nerve canal, thus suggesting benign lesion. Anatomopathological examination showed inflammatory epulis. Clinical and radiological assessment was performed 15 days after surgery and showed good healing without pain or infection. Given the clinical and radiological findings, differential diagnoses included squamous cell carcinoma, metastasis from prostatic adenocarcinoma, inflammatory epulis or lymphoma. [ABSTRACT FROM AUTHOR]

Congenital granular cell epulis (CGCE) is an uncommon benign lesion found in newborns. It has predominance for females with an 8:1 ratio in relation to males and is exclusively encountered in the oral cavity. The most affected oral site is located around the canine/incisor region of the maxillary alveolar ridge, where the lesion arises from the soft tissue as a solitary pedunculated mass. CGCE's histogenesis remains obscure and controversial. We present a rare case of 2 separate CGCE lesions adjacent to each other measuring 23 × 18 × 10 and 15 × 10 mm, positioned facially on the right maxillary alveolar process. The patient, a 2-day-old female newborn, did not experience any serious difficulty regarding breathing or deglutition. Complete surgical excision was the treatment of choice in this case, and the procedure was performed under both general and local anesthesia. Histologic and immunohistochemical analysis confirmed the diagnosis of CGCE. The patient showed satisfactory postoperative healing and excellent health at both the 10-day recall appointment and the 6-month follow-up.

Congenital granular cell tumor of the newborn is a benign, relatively innocuous hamartomatous lesion arising from the alveolar ridge. Large lesions often warrant prompt surgical removal owing to the associated difficulty in breastfeeding and respiration of the infant. However, for medium-sized lesions, another approach could be observed for spontaneous regression. The present case report highlights the use of a combination approach for management of tumor in a 2-day-old female child presenting with a large protruding mass from the mouth associated with difficulty in breastfeeding. A combination of observation for regression in size followed by electrosurgical removal of the tumor was done. The infant was followed up regularly over a long period of 3 years to assess any adverse effects of surgical intervention on the maxillary primary anterior dentition of which none were recorded. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinicopathological features including variations of fifty oral pyogenic granuloma cases reported to Department of Oral medicine and Radiology, Dhule. Materials and Methods: A retrospective review for the fifty cases reported as PG was performed, and data for the following parameters were recorded: age, gender, history of trauma or any other etiology, site and clinical presentation, variation in histology, treatment mode, and recurrence. Results: PG was most commonly seen in the second (36%) and third (46%) decade, with a female preponderance (male: female 1:4). Gingiva was more commonly involved (90%) followed by the lip (6%) and ventral surface of the tongue (4%). Classic clinical presentation of PG exhibited as a sessile or pedunculated, firm or soft, erythematous, exophytic, and/or painful papule or nodule with a smooth or lobulated surface that bleeds easily. Conclusion: Although it is a benign lesion which is commonly encountered and excised in dental practice, it is important to recognize these variants to avoid misdiagnosis, it is always wise to subject it to histopathological confirmation owing to its close clinical resemblance to neoplastic condition. [ABSTRACT FROM AUTHOR]

Peripheral ossifying fibroma (POF) is a reactive lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. It originates from the cells of the periodontal ligament. The definitive diagnosis is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Surgical excision is the treatment of choice, though the recurrence has been reported. We present a clinical, radiological and histological review of five cases of POF diagnosed and treated at our institute.

L'épulis (épi = dessus, oulon=gencive) est une pseudotumeur bénigne hyperplasique circonscrite des gencives, la plus fréquente, elle répondra à deux critères qui font l'unanimité: un critère topographique: la localisation de l'épulis au niveau du collet d'une ou de deux dents contiguës; un critère de bénignité bien précisé par LAUFER: '' l'épulis est en effet une tumeur qui ne récidive pas après exérèse complète, qui ne donne pas de métastases, ni d'envahissement ganglionnaire ''. Classiquement, le rôle de l'inflammation seul est retenu pour expliquer l'étiopathogenie. Mais de troubles humoraux souvent observaient a type de variation ou perturbation endocrine, hypovitaminose C, troubles hématologiques. L'épulis s'observe à tout âge et se présente cliniquement sous forme de masse charnue rouge foncé très vascularisée, saignant facilement au contact, circonscrite sessile ou pédiculée, Histologiquement, l'épulis distingue différentes formes: simples, inflammatoires, vasculaires ou angiomateuses, fibreuses, à cellules géantes ou épulis à myéloplaxes. Son traitement est l'exérèse chirurgicale. Nous rapportons le cas d'une patiente de 76 ans, sans antécédent particulier, consultait pour des tumeurs de la gencive évoluant depuis 3 ans. L'examen clinique objectivait au niveau de la gencive inférieure et inferieure deux masses indolores, exophitiques, en forme de framboise, ferme, à base sessile saignant au contact, avec un mauvais état bucco-dentaire. Le reste de l'examen clinique était normal, une radiographie panoramique réalisée était sans particularité. Le diagnostic d'épulis a été retenu. Ainsi l'exérèse chirurgical avec examen anatomopathologique a confirmé le diagnostic. L'évolution était bonne avec des soins dentaires réguliers.

Congenital Granular Cell Tumour (CGCT) is a rare benign soft tissue tumour of newborn, different from adult GCT. The tumour has a strong predilection for the maxillary alveolar ridge with a female preponderance. Here we report an unusual case of congenital granular cell epulis in the mouth of a 2 hour old female newborn. She had a round, soft, pedunculated mass measuring (2x 2x1) cm. which was causing feeding difficulty. This case was reported as congenital granular cell epulis. We are presenting this case because of its rare nature and uncommon presentation at this age.

Dentinal hypersensitivity and unesthetic appearance are common findings after excision of an epulis due to exposure of root and underlying bone. The simultaneous placement of subepithelial connective tissue grafting after excision of the lesion seems to be viable surgical option in such cases. Furthermore, this will avoid second surgical procedure for the management of the residual gingival defect.

Congenital epulis (CE) also known as congenital granuler cell tumor is a very rare tumor in newborns, which has a female preponderance. CE with unclear histogenesis and etiology is seen at birth as a huge, solitary mass protuberant from oral cavity. The tumor usually originates from maxillary or mandibular gingiva and can cause feeding and/or respiratory handicap. The treatment is simple excision of the mass surgically which should not be delayed. CE has a benign histopathology and after surgery there is no reccurence reported in the literature. We operated a 4 hour-old female newborn due to intraoral mass causing deglution problem. The histopathology was reported as congenital granular cell tumor and this case is discussed based on the current literature because of its rarity.

Congenital granular cell tumor is very rare and it arises from the gum pad of neonates. Surgery is required immediatly after birth as the tumor interfares with feeding and respiration. Although a benign tumor, it can create immense anxiety amongst the attending physician and family members. Its recognition is important so as to avoid over diagnosis leading to radical surgery. We report a case of congenital epulis arising from the maxillary alveolar ridge in a newborn female child, which was successfully excised and the diagnosis confirmed histologically. No tumor recurrence has been reported in the patient postoperatively. Keywords: Congenital; Epulis; Granular cell DOI: 10.3126/jpn.v1i1.4458 Journal of Pathology of Nepal (2011) Vol.1, 69-72

Epulis is a relatively common gingival swelling and is often due to inflammation. It is seen more commonly in females. A careful clinical examination followed by thorough radiographic investigation is required to rule out lesions such as peripheral ossifying fibroma which depicts calcifications. Here we present three cases which have a relatively similar clinical picture but varied in there radiographic and histopathologic appearance. The management and post treatment follow up of the cases are also discussed in detail.