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Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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.

Congenital granular cell tumor (CGCT), or congenital epulis (CE), is an uncommon benign soft tissue lesion that usually arises from the alveolar mucosa of neonates. It can be found in the jaw, skin, gastrointestinal, and respiratory tract. It is seen more frequently in female neonates. It can sometimes lead to feeding and respiratory problems. The etiology is unknown although origin from vascular pericytes or smooth muscle is speculated. As most of the granular cell tumors are benign, surgical excision of the lesion is the treatment of choice. We here present a case report of a 14-hour-old female infant, who had a solitary mass on the anterior maxillary alveolar ridge. The lesion, which was histologically a CGCT, was removed completely by simple excision. [ABSTRACT FROM AUTHOR]

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]

Congenital epulis is a rare and benign newborn tumor. There are some papers on this entity; however, very few reports focus on its macroscopic view. We present a newborn girl with multiple congenital epulis of the mandibular and maxillary alveolar ridges who underwent a successful surgical intervention in a resource-limited setting. Congenital epulis is frequently diagnosed by histopathological examination, although sonography could be helpful before birth. Despite the benign nature of the disease, immediate intervention is often required as it can prevent feeding and cause asphyxia in neonates. Surgical excision is the standard treatment. Congenital epulis can be identified clinically shortly after birth. They cause a substantial surgical challenge due to multiple or large lesions and problems with breathing and feeding. Surgical repair must be performed as early as possible. [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.

Congenital granular cell epulis (CGCE) is a rare tumor of gingiva that is exclusive to newborns, has marked female predominance, and is rarely associated with other abnormalities. Although benign in behavior, CGCE can be lethal by obstruction of respiration and/or deglutition and can require a multidisciplinary team of specialist at birth for survival of an otherwise normal infant. Histologically, CGCE resembles granular cell tumor (GCT), but unlike GCT, which is Schwannian-derived, derivation of CGCE remains an enigma, largely because of its low prevalence. This study presents 24 new cases of CGCE, the largest series since the original description 150 years ago and permits detailed study of homogeneity of cases diagnosed as CGCE as well as detailed comparisons of CGCE with GCT by clinical, morphological, immunohistochemical, and ultrastructural studies. The data show homogeneity within the CGCE cases, more differences than similarities between CGCE and GCT, and no immunohistochemical staining for common placental proteins/hormones in CGCE. The findings support a primitive mesenchymal cell origin, and a progressive degenerative process in CGCE, rather than neoplasia. Prenatal detection of this lesion is important to facilitate adequate preparations for support of these infants during labor and delivery. [ABSTRACT FROM AUTHOR]

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.

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]

Copyright of Journal of Research in Dental Sciences is the property of Islamic Azad University, Dental Branch and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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.

Background Congenital epulis is a benign tumor of upper gingiva. Larger lesions interfere with mouth closing and normal feeding and may obstruct airways. We present a neonate with a large epulis. Case Report: A full term 3 kg 5 days female baby had a 20 cm × 15 cm gingival mass protruding from the oral cavity, connected by a pedicle attached to right upper gingiva (Figure 1). Multiple trophic ulcers had developed in the mass after birth. Mouth closing and normal feeding were hampered. The mass was excised surgically and baby improved. Conclusion: A large congenital epulis, though worrisome to parents, can be satisfactorily managed by surgical excision and has a good prognosis. [ABSTRACT FROM AUTHOR]

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]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction A large number of lesions of various etiopathogenesis may be found in the oral cavity. They range from benign inflammatory-hyperplastic changes to malignant tumors. The following study aims to statistically show the frequency and type of changes depending on the age and sex of patients treated in the Department of Dental Surgery of the Medical University of Warsaw. Material and methods 612 results of histopathological examinations of sections or entire lesions of the oral cavity collected from patients in the years 2012-2017 were analyzed. The results were analyzed in terms of gender, age and the site of tissue collection. Neoplasms and 8 other groups of lesions of the mucosa were distinguished. Results The most common lesion was fibroma (35%), followed by a chronic inflammatory process (15.4%), and salivary gland cysts (11.9%). Papillomas (HPV) accounted for 10.5%, epilemomas 9.64%, tumors 6.54%, cysts and ulcers 4.74% and 4.25%, respectively. Pre-neoplastic lesions were found in 70 cases. These included ulcerations, leukoplakia, changes with metaplasia, dysplasia and pseudo-neoplastic hyperplasia. The most common localization of pathological changes in the oral cavity was related to the gums. Conclusions Many lesions of various etiology may present with a similar clinical manifestation. Therefore, in order to correctly diagnose pathological changes in the oral cavity, it is necessary to conduct a thorough medical history and physical examination, and identify the factors that may have caused the lesion. A particular group of pathological changes of the oral mucosa are ulcers which, despite a conservative approach, do not respond to treatment. In such cases a neoplasm should be suspected and a section of the lesion be obtained for histopathological evaluation which is the only reliable method that allows a final diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To characterise the role of VEGF, EG‐VEGF and its receptors in the development and progression of HNC. Design: Human serum and tissues samples were collected from healthy, epulis and HNC patients and used for ELISA assays and immunohistochemistry studies, respectively. Setting: Ibn Rochd Hospital of Casablanca (Morocco), INSERM and University of Grenoble Alpes (France). Participants: We used serum from 64 patients with head and neck cancers and from 71 controls without general pathology. Tissues samples were collected from seven patients with OSCC and from seven patients with Epulis. Main outcome measures: We compared circulating VEGF and EG‐VEGF in normal and HNC patients and determined the expression, localisation and quantification of VEGF, EG‐VEGF and its receptors; PROKR1 and PROKR2 as well as Ki67, CD31 and CD34 in OSCC and Epulis patients. Results: Both EG‐VEGF and VEGF circulating levels were significantly decreased in the HNC (P <.01). OSCC patients expressed less EG‐VEGF and VEGF proteins, higher PROKR1 and PROKR2 with no change in CD31 and CD34 levels. A significant increase in Ki67 was observed in OSCC. Conclusions: We demonstrated that circulating VEGF and EG‐VEGF are downregulated in HNC patients and in OSCC tissue. EG‐VEGF receptors were increased in OSCC, along with a stabilisation of two key markers of angiogenesis. These findings strongly suggest that downregulation of angiogenesis in HNC might explain its moderate metastatic feature. [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]

Purpose: To evaluate the efficacy of the Nd:YAG laser therapy in the management of oral mucosal lesions. This retrospective study concerns several clinical cases. Materials and Methods: 130 patients with a variety of benign oral soft tissue lesions were treated with laser excision and ablation. Surgery was performed on all patients with a pulsed, fiberoptically delivered Nd:YAG contact laser (Smarty-10). The most frequent lesions excised or vaporized and biopsied were fibroma (27), epulis (16), leukoplakia (13), lichen planus (13), hemangioma (5), mucocele (13), fiber-mucosa hyperplasia (13), and squamous papilloma (10). All patients were included in a postoperative follow-up program for up to 24 months (range 6 to 24 months). Results: In most cases, Nd:YAG laser therapy led to complete resolution of the lesion. No negative effects were reported during or after this type of laser surgery. Especially for oral mucosal white lesions, this treatment obtained resolution or real control regarding their symptoms and growth. Conclusion: Based on our results and the international literature, Nd:YAG laser therapy can be considered as effective as traditional surgical techniques in the treatment of benign oral mucosal lesions. Moreover, in addition to its therapeutic excellence, this laser method possesses the great advantage of being much more comfortable (no postoperative problems or pain, no need of sutures, often no need for local anesthesia). [ABSTRACT FROM AUTHOR]

Epulis fissuratum also called as Denture-induced hyperplasia (DIH) is a tumor-like hyperplasia of fibrous connective tissue, which develops in association with an ill-fitting complete or partial denture. Virchoft first invented the term "Epulis" and the meaning is "over the gums". However the use of this term is not appropriate as it emphasizes only the actual site of the lesion. In most cases, the affected mucosa is usually the oral mucosa of the vestibular sulcus or the palatal region. Therefore, "Denture-induced fibrous hyperplasia" was considered to be a much-preferred term. This is a case report of an 65 year old female with a history of wearing complete denture for 2 years and ended up in developing multiple proliferative growths. [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.

Copyright of dentalTarget is the property of dentalTarget and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hyperparathyroidism (HPT) is a disease characterized by excessive secretion of parathyroid hormone (PTH). In patients with HPT, the chronically increased PTH levels lead to bone loss, osteoporosis and fragility fractures. Bone disease in severe HPT is described classically as osteitis fibrosa cystica. Bone pain, skeletal deformities and pathological fractures are the main manifestations of HPT. The radiologic features of HPT include generalized radiolucency or oval-round radiolucent areas. The most frequent oral clinical manifestations of HPT are: brown tumor, loss of bone density, mobile teeth, drifting of teeth, complaint of vague jaw bone pain, sensitive teeth in mastication and percussion, soft tissue calcifications and dental abnormalities, such as development defects and alterations in dental eruption. Dental management of patients with HPT requires special consideration and precaution regarding surgical treatments. Careful assessment of all radiographic, biochemical and histopathological parameters of patients with HPT by an interdisciplinary team is necessary, in order to establish the surveillance and treatment plan. [ABSTRACT FROM AUTHOR]

Background: Epulis, which is also called granular cell tumor (GCT), is a rare tumor of the newborn. Aims and Objectives: to evaluate the outcome of surgical management of (GCT) and the efficacy of simple excision in neonates at our centers. Materials and Methods: We reviewed the medical records of 10 patients who had simple excision for granular cell tumor (GCT) in the period from 2006 to 2019. Result: This report describes 10 patients with GCT. All were newborns (nine females and one male). They presented with a mass of variable size protruding from the mouth and in five this interfered with feeding. In 7 patients, the mass was solitary, but three had two lesions. One had two masses arising from the maxillary alveolar ridge; one had two masses one arising from the maxillary alveolar ridge, while the other arising from the mandibular alveolar ridge and the third had two masses arising from the mandibular alveolar ridge. All were treated surgically with simple excision which was curative and on a mean follow-up of 3 years (10 months–6 years); there was no noticeable defect in the gum. Conclusion: Simple excision is the treatment of choice of epulis. It is simple, safe, and curative. [ABSTRACT FROM AUTHOR]

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]

Peripheral giant cell granuloma; They are exophytic lesions seen in the gums and alveolar mucosa, arising from the periodontal membrane or connective tissue of the periosteum. Although its etiology is not known, it is stated that there are local irritants such as dental tartar, microbial plaque, traumatic tooth extractions, occlusal trauma, periodontal surgery, malposed teeth, faulty prostheses, food accumulation and orthodontic treatment. Although it is seen in all age groups, it is more common in the 4th and 6th decades. Peripheral giant cell granulomas seen in children have been reported to be more aggressive and cause tooth gaps. It is more common in women than in men and in the mandible than in the maxilla. In this case report, it is aimed to discuss the etiology, clinic, radiological findings and treatment of peripheral giant cell granuloma in the light of current literature. A 7-yearold patient who applied to our clinic complaining of pain due to decayed teeth, had a raised, red-purple pathological formation in the lower left mandibular region. The patient's lesion was excised with cautery and sent to the pathology laboratory. Post-operative control was performed 1 week later and a very successful recovery was observed. It is important for clinicians to correctly diagnose and effectively treat peripheral giant cell granulomas, which are known to be aggressive and have high recurrence, to differentiate them from possible malignancies and to prevent them from damaging the surrounding bone and teeth. [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]

Abstract: While plaque‐induced gingivitis is one of the most common human inflammatory diseases, several non–plaque‐induced gingival diseases are less common but often of major significance for patients. The non–plaque‐induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation. [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.

Objective: It is the aim of this study to evaluate if the CO2 laser can beneficially be applied for excising epulides. Background data: The standard procedure for treating epulides involves the excision of the hyperplastic tissue followed in most cases by the removal of parts of the underlying bone and the final closure of the wound by a flap. The use of the CO2 laser for the treatment of epulides has been documented only in isolated case reports and very few case series. Patients and methods: Ninety patients with different subtypes of epulides were treated with a CO2 laser (Lasram, model OPAL 25, 25 W, 10.600 nm, gas laser); power setting 4 W, continuous wave. The surgery was performed only after a pretreatment could remedy any gingivitis or occlusal trauma. A new surgical way of working using a special applicator that allowed tangential application of the laser beam was applied for all patients. Patients were followed up to 3 years. Results: No perioperative complications or recurrences after 4 weeks could be found. Six patients were lost to further follow-up, whereas 84 patients were followed up to 36 months. In 71 cases there were no recurrences over the entire observation period. Thirteen patients developed a relapse, usually a fibroma/fibrosis according to histopathological evaluation. Conclusions: Overall CO2 laser seems to be an adequate tool for minimally invasive excision of epulides, although the respective histopathological entity could possibly influence the recurrence rate and so should be considered. [ABSTRACT FROM AUTHOR]