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Background: Congenital epulis (CE) also known as congenital granuler cell tumor is a rarely encountered pathology the majority of which originates from the gingival mucosa, particularly the anterior portion of the maxillary alveolar ridge. CE mostly seen in girls. CE with unclear histogenesis and etiology is seen at birth as a solitary mass in oral cavity. Apart from non-congenital epulis, it contains granular cells. So lesion is named congenital granular cell tumor. CE has a benign histopathology and after surgery there is no recurrence reported in the literature. Aim: The purpose of this case report, is to present, 5 day-old female neonatal girl who was seen CE on the left maxillary alveolar ridge on the region of the future incisors. Case Presentation: The tumoral lesion was well-circumscribed and 10 mm in diameter, smooth surfaced and red in colour much like alveolar mucosal tissue. Tumoral lesion was affecting oral feeding due to obstruction. Excisional biopsy was performed under topical anesthesia. The histopathology was reported as congenital epulis. During the 4 months follow-up, we have seen no complication. Conclusion: CE is a neonatal congenital tumor which is very rare. The treatment of CE is surgical excision. Unless the early treatment is not executed, tumor may cause difficulties in oral feeding and respiration. Therefore it should be excised in an early period.

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 involve...

Women are more likely to suffer from gingivitis and periodontitis (gum disease) when pregnant, due to hormonal changes. Women considering pregnancy and those who are pregnant should be advised to visit their dentists to help maintain good oral health throughout their pregnancy. Appropriate dental treatment may be necessary to improve periodontal health. Research has suggested possible adverse complications to pregnancy for women with poor periodontal health. This article serves to highlight the importance of being aware of the association between pregnancy and periodontal disease, and the appropriate treatment for improving and maintaining periodontal health as necessary.

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.

Ascher syndrome is characterized by double lip, blepharochalasis, and non-toxic goiter triad. This condition of unknown etiology usually occurs in patients younger than 20 years of age. In this case report, the authors present the diagnostic process of Ascher syndrome and surgical procedure of double lower lip in a female patient who applied to our clinic for prosthetic reasons. A 70-year old female patient was referred to our clinic with the chief complaint of incompatible dentures. The patient had been using the same complete dentures for 40 years. Extraoral clinical examination revealed protruded, bulged lower lip at rest and bilateral blepharochalasis, defined as atrophy of the upper eyelid skin. The upper lip and lower eyelids were not affected. Intraoral examination revealed complete edentation of both jaws and a double lower lip, an accessory fold of excess mucosae inside the vermillion border. Furthermore, epulis fissuratum was observed in the lower jaw. There was no family history of double lip. The patient stated that she had noticed another lip inside her lip for several years. As Ascher syndrome was suspected, the patient was referred to the endocrinology department for thyroid examination, and the non-toxic goiter diagnosis was confirmed. Surgical removal of the redundant tissues was necessary because of deficiencies in speech, chewing, and aesthetics. The excess tissues were excised by transverse ellipse incision technique. Dentists should be familiar with Ascher syndrome, as they may be the first physicians to encounter patients with double lip. C1 [Ozdede, Melih] Pamukkale Univ, Fac Dent, Dept Dentomaxillofacial Radiol, Denizli, Turkey. [Dere, Kadriye Ayca] Pamukkale Univ, Fac Dent, Dept Oral & Maxillofacial Surg, Denizli, Turkey.

Epulis is any tumor like growth present in the oral cavity. Epulis granulomatosum is an enlargement of the soft tissue originating from the extraction socket and is thought to be a post extraction sequel. It is considered to be a benign exuberation of the soft tissue in the form of a hyperplastic reaction.

In this chapter fine needle aspiration cytology (FNAC) of a swelling in the hard palate in a child is discussed.

Introduction. Epulis is benign tumor of the oral cavity which develops from alveolar tissue. Fibromatous epulis is common for both male and female. The children are diagnosticated with angiomatous form of epulis.The tumor is revealed during the period of mixed occlusion in the pediatric dentistry. The result of it is a retention of permanent teeth, a divergence of teeth roots. It has been recorded some cases with epulis of newborns. Aim of study. Optimization of surgical technique of treatment of epulis in children.Materials and methods. Evaluation of the pathological process was carried out on the basis of anamnesis and clinical data of the patient K., 12 years. Additional methods of examination - targeted intra-oral radiography of the pathological process, histological examination. Treatment is operative, dispensary observation within 6 months.Results. The treatment tactics was to cut the epulis under local anesthesia. The excised material was sent for histological examination, the results of which confirmed the diagnosis of angiomatous epulis. Recommendations are given after surgery. Dispensary monitoring was carried out for 6 months.Conclusion. Nowadays the most effective treatment of epulis is surgical. It is necessary to do roentgenologic and histological examination for specification of diagnosis, Вступление. Эпулис – доброкачественная опухоль полости рта, которая происходит из тканей пародонта. Фиброматозный эпулис одинаково часто встречается у лиц обоего пола. Ангиоматозную форму диагностируют как правило у детей. В детской стоматологии опухолевидное образование чаще всего проявляется в период сменного прикуса. Как следствие – ретенция постоянных зубов, дивергенция корней. Зафиксированы единичные случаи возникновения эпулиса у новорождённых.Цель исследования. Оптимизация хирургической методики лечения эпулиса у детей.Материалы и методы исследования. Оценка патологического процесса осуществлялась на основе анамнеза и клинических данных пациентки К., 12 лет. Дополнительные методы обследования – прицельная внутриротовая рентгенография участка патологического процесса, гистологическое исследование. Лечение оперативное, диспансерное наблюдение в течение 6 месяцев.Результаты исследования. Лечебная тактика заключалась в иссечении эпулиса под местным обезболиванием. Высеченный материал был отправлен для гистологического исследования, результаты которого подтвердили диагноз – ангиоматозный эпулис. Даны рекомендации после оперативного вмешательства. Проведено диспансерное наблюдение в течение 6-ти месяцев.Выводы. Самым эффективным методом лечения эпулиса является хирургический. Для уточнения диагноза необходимо проводить рентгенологическое и гистологическое исследование., Вступ. Епуліс – доброякісна пухлина порожнини рота, що походить із тканин пародонта. Фіброматозний епуліс однаково часто зустрічається в осіб обох статей. Ангіоматозну форму діагностують переважно у дітей. У дитячій стоматології пухлиноподібне утворення найчастіше виявляється в період змінного прикусу. Як наслідок – ретенція постійних зубів, дивергенція коренів. Зафіксовані поодинокі випадки виникнення епуліса у новонароджених.Мета дослідження. Оптимізація хірургічної методики лікування епулісу в дітей.Матеріали та методи дослідження. Оцінка патологічного процесу здійснювалася на основі анамнезу та клінічних даних пацієнтки К., 12 років. Додаткові методи обстеження – прицільна внутрішньоротова рентгенографія ділянки патологічного процесу, гістологічне дослідження. Лікування оперативне, диспансерне спостереження протягом 6 місяців.Результати дослідження. Лікувальна тактика полягала у висіченні епуліса під місцевим знеболенням. Висічений матеріал було відправлено для гістологічного дослідження, результати якого підтвердили діагноз – ангіоматозний епуліс. Дано рекомендації після оперативного втручання. Проведено диспансерне спостереження протягом 6-ти місяців.Висновки. Найефективнішим методом лікування епуліса є хірургічний. Для уточнення діагнозу необхідно проводити рентгенологічне та гістологічне дослідження.

Background Epulis has a tumor‐like appearance but is considered to be a massive reactive lesion rather than a true neoplasia. Limited information about the pathogenesis of epulis is available. The purpose of our study was to identify potential signaling pathways in fibrous epulis through transcriptome profiling. Methods Differentially expressed genes (DEGs) between fibrous epulis lesions and normal gingival tissues were detected using RNA sequencing (RNAseq). The expression levels of eighteen genes were validated using quantitative real‐time PCR (qRT‐PCR). Results RNAseq identified 533 upregulated genes and 732 downregulated genes. The top 10 upregulated genes were IL11, OSM, MMP3, KRT75, MMP1, IL6, IL1B, IL24, SP7, and ADGRG3. The top 10 downregulated genes were BCHE, TYR, DCT, KRT222, RP11‐507K12.1, COL6A5, PMP2, GFRA1, SCN7A, and CDH19. KEGG pathway analysis further indicated that the DEGs were enriched in “Pathways in cancer” and the “Ras signaling pathway”. quantitative real‐time PCR verified that the expression levels of SOS1, HRAS, PIK3CA, AKT3, IKBKA, IKBKB, NFKB1, BCL2, BCL2L1, XIAP, BIRC2, and BIRC3 were increased significantly. Conclusions The current transcriptomic profiling study reveals that in fibrous epulis, RAS‐PI3K‐AKT‐NF‐κB pathway transcriptionally regulates the expression of BCL2 family and IAP family genes, leading to increased proliferation and apoptosis inhibition.

Background: The aim of this study was to compare the clinical effects between traditional surgery and minimally invasive periodontal surgery in the treatment of epulis. Methods: A total of 33 cases of patients diagnosed with fibrous epulis were randomly divided into traditional surgery group and minimally invasive periodontal surgery group. After the different procedures, several parameters were detected to evaluate the effects of minimally invasive periodontal surgery. Results: Preoperative bleeding index and plaque index, adopt rank, and test showed no significant differences between the 2 groups. After 12 weeks, gingival papilla filling index in experiment group is statistically higher than control group, and shows the statistical differences (P

Background Congenital epulis is a rare benign oral cavity tumor that usually arises from the maxillary alveolar mucosa. It is also known as congenital gingival granular cell tumor. This tumor can interfere with respiration and feeding. Prenatal diagnosis is uncommon and mostly confined to the third trimester. Case report A 30-year-old woman, gravida 5, para 3, had an ultrasound examination at 30 weeks of gestation. A intraoral mass was noted to fill the fetus’s oral cavity. Therefore, the woman was referred to our departement of neonatology, but she refused the complement of th explorations and the transfer. At 37 weeks of gestation, an elective cesarean section was performed. The newborn female child weighed 3 kg who had a large mass occupying the oral cavity. The mass prevented normal closure of the mouth and interfered with breastfeeding, but did not pose an immediate airway concern. She was referred to our departement immediately after birth. On clinical examination, a pedunculated mass, exhibiting a grey ulcerated surface was located on the left side of the maxillary alveolar ridge. This mass measured 6 cm × 4.5 cm × 3 cm and prevented normal closure of the mouth and interfered with breast or bottle-feeding, but did not cause airway obstruction or respiratory distress. Examination of other systems was normal. A surgical excision of the mass was performed on the second day of neonatal life confirmed the presence of a tumor resembling epulis. The correctness of this diagnosis was subsequently confirmed by histogenesis. The intraoperative and postoperative courses were uneventful. The newborn recovered with no complications, and breastfeeding was initiated on the subsequent day of operation. Conclusion Early diagnosis of CE in a newborn is of paramount importance in the successful management of these rare cases.

Background Adenomatoid odontogenic tumor constitutes an uncommon benign odontogenic tumor which is well-known as “two-thirds tumor” (two-thirds of adenomatoid tumors occur in the maxilla, two-thirds occur in young females, two-thirds of the cases are associated with un-erupted teeth and two-thirds of the affected teeth are canines). Larger part of these present as intra - osseous tumors while peripheral counterparts are extremely rare. Peripheral adenomatoid odontogenic tumor is a unique entity which generally presents as a slow growing gingival swelling with minimal bone involvement. This often leads to its erroneous diagnosis as a simple gingival lesion and the real diagnosis is only revealed after its microscopic evaluation. It exhibits a marked predilection for maxillary gingiva of incisor region and most commonly affects the younger females. Case presentation We report a case of 25 years old female patient of African ethnicity who presented with a 2 × 2 cm mass attached to the left mandibular gingiva in cuspid- bicuspid region which is an unusual site for AOT. It was accompanied by slight bone loss. With the differential diagnosis of gingival epulis and peripheral ossifying fibroma; surgical excision was performed. The light microscopic examination of the specimen aided the final diagnosis of Adenomatoid odontogenic tumor with the histopathological features identical to its intra osseous counterpart. Conclusion In this case, the tumor is present on the mandibular gingiva in a 25 years old patient which is an atypical location and age for this tumor; also, the only individual case reported in an African patient. Only, a meager number of peripheral adenomatoid odontogenic tumor cases have been logged so far with majority of them occurring in maxillary gingiva. Furthermore, an ambiguity still prevails regarding its true origin and possible biological course. Hence, reporting of similar cases should be encouraged to facilitate the better understanding of its varied epidemiological details and clinical presentation.

Background Epulis is a nonspecific historical term applied to localized enlargement of gingiva. Although gingival enlargement often develops because of simple reactive lesions, it sometimes may also be the clinical presentation form of malignant and benign neoplastic lesions. Objective and Methods A total of 90 cases with a clinical diagnosis of “epulis” were included in the study. Histopathologic findings of the cases were analyzed with demographic and clinical information. Results Of the 90 patients, 65 were female (72.2%) and 25 were male (27.8%). The mean age was 40.13 ± 18.04 years (range, 6 days to 78 years) and about one-third of cases were discovered in the fifth decade. The most frequent localization was mandibular gingiva (50 cases) compared to the maxillary gingiva. Histopathologically, reactive lesions were detected in the vast majority of cases and only 11 cases had a neoplastic lesion (12.2%). The most detected reactive lesion was peripheral giant cell granuloma (38.9%), followed by focal fibrous hyperplasia (35.6%) and pyogenic granuloma (13.3%). Of the 11 neoplastic lesions, 6 benign tumors (2 congenital granular cell tumor, 1 lipoma, 1 osteoma, 1 peripheral developing odontoma, and 1 peripheral ossifying fibroma) and 5 malignant tumors (2 Langerhans cell histiocytosis, 1 malignant melanoma, 1 mucoepidermoid carcinoma, and 1 osteosarcoma) were diagnosed. Conclusions In our study, neoplastic lesions were detected in 12.2% of patients and the risk of malignancy was determined as 5.5% in lesions presented by epulis. Histopathologic examination is a gold standard for differentiation of such lesions.

Oral metastasis, although rare, tends to involve jawbones, particularly the posterior region of the mandible, and involvement of oral soft tissues, even when less likely, is most often seen on the gingiva and tongue. Clinically, the soft-tissue masses tend to mimic pyogenic granuloma, peripheral giant cell granuloma or an epulis and thus are difficult to diagnose and identify. The jaw bone is preferred by prostate carcinoma as a metastatic target. Prostate malignancy, which is more common in Western countries than in India, may be adenocarcinomas or carcinomas. Oftentimes, metastatic lesions develop in the alveolar region and are a cause for tooth mobility, yet, they tend to be detected only after extraction of the affected tooth. In such cases, the symptomatic presentation therefore, is vague and indicative of tooth mobility secondary to periodontal pathology unless, a detailed history and follow-up is done. We report a case of a male patient who presented to our department with a proliferative, painful, swelling postextraction of the left first molar region, and the lesion was seen at the extraction site as well as in the mandibular anterior tooth region. The swelling was associated with palpable lymph nodes. Orthopantomogram showed an irregular, radiolucent lesion extending from the lower left central incisor to the left first molar region in the mandibular alveolus. Incisional biopsy tissue came with provisional diagnosis of osteomyelitis or squamous cell carcinoma as the patient was a habitual bidi smoker for more than 20 years. Histologically, it was an undifferentiated tumor with tumor cells seen in deep connective tissue with a lack of lineage differentiation. An undifferentiated malignant tumor represents either a metastasis of unknown origin or a primary neoplasia without obvious cell line of differentiation. Immunohistochemistry (IHC) of undifferentiated tumors helps to categorize them into small round blue cell tumors or large cell tumors. The oral pathologist was perplexed as there was no mention of any other malignancy in the patient's history, which, however, was noted by the surgeons few days later. Hence, initially, a hematopoietic malignancy was suspected which was ruled out by IHC, and later, staining with cytokeratin 7 (CK7), CK-high molecular weight and P63 confirmed prostate metastases as all three were negative.

A epúlide congênita é um tumor benigno e raro que acomete a mucosa oral de recém-nascidos. Apesar de ser benigna, esta lesão pode atingir extensa dimensão e prejudicar a função do complexo maxilomandibular tanto para alimentação, quanto para respiração, devendo então ser diagnosticada o mais precocemente possível para que seja realizada sua remoção. O presente artigo tem como objetivo relatar um caso de diagnóstico e tratamento de uma recém-nascida com epúlide congênita de grandes proporções. Paciente M.C.A., leucoderma, 2,7kg, gênero feminino e normorreativa, apresentava no exame físico do período pós-natal imediato, uma lesão nodular, lisa, não-ulcerada e pediculada com 40 milímetros em seu maior diâmetro, localizada em mucosa alveolar vestibular de maxila direita. Com a integração multiprofissional entre a equipe médica de pediatria, radiológica e cirurgia buco-maxilo-facial, foram solicitados e avaliados os exames de tomografia computadorizada e ultrassonografia com doppler para avaliação do fluxo sanguíneo da lesão e exclusão definitiva do diagnóstico diferencial de hemangioma. O procedimento de exérese foi realizado sem intercorrências sob anestesia geral, quando o paciente datava onze dias de vida. A peça anatômica foi enviada para avaliação histopatológica e imuno-histoquímica, que confirmaram o diagnóstico clínico de epúlide congênita. A paciente apresentou recuperação nutricional imediata e evoluiu satisfatoriamente. A epúlide congênita por se tratar de uma condição rara, acaba sendo muitas vezes subdiagnosticada e confundida com lesões vasculares, por isso, a abordagem multiprofissional direciona o diagnóstico e o tratamento de forma adequada.

An unusual case of a 1-day-old Chinese female neonate with a solid tumor mass in the maxillary anterior ridge of the edentulous jaw is reported. Based on the clinical and histopathological features, the diagnosis was of obstructive congenital granular cell epulis (CGCE) which is an uncommon benign tumor that preferentially develops in female infants. Immunohistochemical analysis of the lesion was performed and the rate of cell proliferation was determined by immunostaining with Ki-67 and PCNA, which showed labeling indexes of 11.1% and 33.3%, respectively. No recurrence was observed in the follow-up.

Introduction: Epulis fissuratum is often formed as a result of a poor fitting denture. The conventional treatment for this fibrous hyperplastic tissue is to excise it using a scalpel and to close the wound by a continuous or an interrupted suture. The increased utilization of lasers in dentistry also includes the utilization of carbon dioxide (CO2) lasers in place of surgical scalpels in soft tissue surgeries. The objective of this study is to assess the feasibility of utilizing CO 2 laser in place of scalpel in surgical treatment of epulis fissuratum. Methods: In this clinical trial research (IRCT code: IRCT2016071124969N2), 19 patients were selected with nearly symmetrical epulis fissuratums in the anterior part of the jaws. The hyperplastic tissue was evenly divided into two sections in each patient. One section was randomly selected and cut by CO 2 laser and the other section by a surgical scalpel. The wound created by the scalpel was closed by appropriate number of interrupted sutures. Surgery duration and bleeding as well as vestibular depth, re-epithelialization and edema in both sections were noted and recorded after 7 and 14 days postoperatively. Results: The time of surgery and the amount of bleeding during surgery in the laser section was less and the vestibular depth was more than surgical scalpel section ( P < 0.05). Surgical scalpel wound at day seventh healed significantly better than the section treated by the CO 2 laser ( P < 0.05). Wound in both sections healed similarly on day 14 and no statistical difference was observed. Edema presence was also equal in both sides after 7th and 14th following the surgery. Conclusion: According to the results it could be concluded that the use of CO 2 laser may result in less surgery time, less bleeding during surgery, more vestibular depth, better re-epithelialization of the wound and less need for suturing. CO 2 laser may be a clinically preferred method for surgical treatment of epulis fissuratum.

This study describes a case of myxoid chondrosarcoma of the mandible in a 22-year-old male patient. A tumour in the buccal gingiva of the lower left premolar region had been identified 2 years earlier. Whole-jaw panoramic radiographs showed a hypodense shadow in the mesiodistal area near the roots of teeth 34 and 35. A maxillofacial computed tomography scan revealed a mass in the lower left premolar soft tissue, with a shadow indicating bone destruction, a clear boundary and uniform density. The preliminary diagnosis at the outpatient department was 34–35 epulis. The patient underwent surgery for 34–35 gingival tumour resection, 34 and 35 extraction, and 34 and 35 immediate implantation. The postoperative pathological examination revealed a cellular type extraskeletal myxoid chondrosarcoma of the lower left mandible. Under general anaesthesia, the patient underwent lower left mandibular block and segmental resection, submandibular triangle dissection and vessel disassociation, and musculocutaneous flap repair in the oral and maxillofacial defect area. After 9 months of follow-up, the patient had no complaints of discomfort, and tumour recurrence was not observed on imaging examinations.

Vascular epulis is a rare clinical disease. In our study, a case of vascular epulis in the cosmetic area was treated by diode laser, without recurrence and obvious inflammation in the surgical site 5 years after surgery. This case report indicates that the excision of vascular epulis in the cosmetic area of the anterior teeth by diode laser could be an alternatively safe and complementary approach in lieu of conventional surgery.

Congenital granular cell epulis is a very rare tumor first described by Neumann in 1871. It is of mesenchymal origin with the female predilection in the ratio of 8:1. The lesion appears as a large protuberant mass and is commonly associated with obstruction causing difficulty in feeding and deglutition. We report a case of a newborn female who had feeding difficulty because of a protuberant mass arising from the oral cavity. The mass was surgically excised under general anesthesia and was histopathologically proven as congenital granular cell epulis. The follow-up for 3 months showed no recurrence. There are reported complications prenatally and postnatally. Hence, the treatment should be initiated early. The treatment of choice is complete surgical excision and no recurrence has been reported.

Background: Congenital granular cell epulis (CGCE) is an extremely rare intraoral tumor of the newborn with a potential to disrupt feeding and produce respiratory distress. Case Series: We report two newborns presented with mass protruding off the mouth since birth. The mass was arising from alveolar ridge in both cases and dealt with surgical excision. Histopathology revealed it congenital granular cell epulis. Postoperative recovery and follow-up are uneventful. Conclusion: Congenital granular cell epulis is a benign lesion though not quite uncommon, may cause diagnostic challenges. Early excision and histopathology rule out malignant lesions.