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This article compares the clinical and histopathologic features of the peripheral odontogenic fibroma in human beings and the fibromatous epulis in dogs. They are apparently equivalent lesions. Both are odontogenic tumors of limited growth potential that do not recur if adequately excised; both occur in middle and late adulthood of the species concerned. The one difference is that the peripheral odontogenic fibroma is a rare condition, whereas the canine fibromatous epulis is common.

A case of congenital epulis in a triple X infant, whose intra-oral mass was first detected on a 33-week prenatal ultrasound, is described. Two previous ultrasound studies performed at 21 and 28 weeks' gestation showed normal facial anatomy, suggesting accelerated tumour growth during the third trimester. Genetic amniocentesis also showed the infant to possess a 47, XXX karyotype.

Congenital granular cell epulis (CGCE), a rare benign lesion arising from the mucosa of the alveolar ridges of the jaws in newborns, has a clinical course characterized by lack of further growth after birth. Histomorphologically, it resembles a granular cell tumor (GCT) of the adult. The histogenesis of this lesion is unclear. We submitted a series of five CGCEs to a large panel of antibodies in order to trace the origin of the constituent granular cells. The resultant immunohistochemical profile showed positivity of these cells to vimentin, NKI/C3, and PGP9.5. This does not confirm any particular cell type for the histogenetic origin of CGCE but may rather reflect a local metabolic or reactive change, providing supporting evidence that the lesion is of a non-neoplastic nature. In addition, the granular cells were non-reactive for S-100, NGFR/p75, and inhibin-alpha, which further contributes to the distinction between a CGCE and the adult GCT.

Purpose: To describe a case of congenital epulis with multiple lesions, which was treated combining surgical resection of the largest tumor and monitoring of the smaller lesions. Case description: A white female newborn showed a large (2.4x1.8x1.1cm), pinkish-red, nodular formation on the left side of the maxillary alveolar ridge, which was preventing mouth closure and causing feeding difficulties. Other small polyps were present on the left side of the mandibular ridge. Excisional biopsy under general anesthesia allowed for the complete removal of the irregular, bilobed maxillary tumor. The diagnostic hypothesis of congenital epulis of the newborn was confirmed based on both the anatomic details and immunohistochemical profile of the lesion. The smaller mandibular tumors were not resected; complete spontaneous remission occurred within 6 months. After surgery, the patient showed substantial clinical improvement, with complete functional and esthetic rehabilitation. No recurrence was observed. Conclusion: Treatment allowed the reestablishment of vital functions and normal neonatal development. The surgical approach improved the infant’s quality of life and restored the parents’ confidence and emotional stability. Key words: Gingival neoplasms; epulis, congenital; surgery Objetivo: Descrever um caso de epúlide congênita com lesões múltiplas, onde foi realizada a exérese total do tumor maior e o monitoramento dos tumores menores. Descrição do caso: Um sujeito neonato do gênero feminino apresentava uma formação nodular grande (2,4x1,8x1,1cm), vermelha-rosada, no lado esquerdo do rebordo alveolar superior, a qual estava dificultando o fechamento bucal e causando dificuldades de alimentação. Outros pólipos menores estavam presentes no lado esquerdo do rebordo mandibular. A biópsia excisional sob anestesia geral permitiu a remoção complete do tumor superior, com aspecto irregular e bilobulado. A hipótese diagnóstica de épulis congênita do recém-nascido foi confirmada com base nos detalhes anatômicos e no perfil imunoistoquímico da lesão. Os tumores mandibulares menores não foram excisionados; a remissão espontânea completa ocorreu dentro de seis meses. Após a cirurgia, a paciente mostrou melhora clínica significativa com completa reabilitação funcional e estética. Não houve recorrência nas visitas subseqüentes. Conclusão: O tratamento permitiu o restabelecimento das funções vitais e do desenvolvimento normal do neonato. A abordagem cirúrgica melhorou a qualidade de vida da criança e devolveu confiança e estabilidade emocional aos pais. Palavras-chave: Neoplasias gengivais; epúlide congênito; cirurgia

We report the case of a 4-month-old Caucasian male baby who presented an uncommon mass in the anterior mandibular ridge. The patient was born with two natal mandibular incisors, which exfoliated some weeks after birth, followed by a growth of nodular lesion in the same region. Based on the clinical and histopathological features, the diagnosis was of myxoid calcified hamartoma. Immunohistochemical and scanning electron microscopic analysis of the lesion were performed. Hamartomas in the mandibular ridges associated with natal teeth are rare, but they must be considered in the differential diagnosis of common lesions, such as congenital granular cell epulis.

The oral cavity contains many organs and tissues compressed in a small area. Accordingly oral tumors have a wide variety of appearances. Reactive hyper-plastic lesions include epulis,morsicatio,traumatic ulcer or palatal hyperplasia. These benign lesions must be separated clinically and histologically from precancerous and neoplastic lesions. In leukoplakia,the individual risk can be estimated by clinical signs. Nevertheless histopathology is mandatory because precancerous lesions usually precede or accompany most oral cancers. Amalgam tattoo,oral nevi and melanoacanthoma have to be considered as differential diagnoses of oral melanoma. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy. Oral soft tissue tumors such as Kaposi sarcoma and multiple mucosal neuromas in MEN 2b require interdisciplinary management. Diseases affecting the minor salivary glands which may be encountered by dermatologists include mucocele, necrotizing sialometa-plasia,and tumors such as pleomorphic adenoma.

An 11-year-old neutered male domestic shorthair cat was presented with an epulis. A hemispherical mass, 8 mm in maximum diameter, without a peduncle and bright reddish in colour, was observed on the gingiva of the left mandible. Radiography failed to show any infiltrating osteolysis. The epulis was surgically removed via gingival incision around the margin to the depth of connective tissue layer. Histopathological examination indicated that the epulis contained a large number of multinucleated giant cells (MGCs) intermixed with mononuclear mesenchymal cells in a loose fibrovascular stroma. Mitotic cells were found, mainly in the centre of the mass. MGCs were stained positive by the tartrase resistant acid phosphatase (TRAP) staining, indicating osteoclasts activity. Immunohistochemical staining for proliferating-cell nuclear antigen (PCNA) was observed within the majority of mononucleated cells, whereas multinucleated cells did not stain. An osteoclast-like giant cell tumour was concluded in this case. The origin of epulis is likely from the periosteal tissue. The cat recovered uneventfully and no recurrence has been noted for 3 years thereafter.

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.

Periodontics deals with surgeries of the gingiva and soft tissues in the vicinity of teeth. In Periodontics, the amount of gingiva is a critical factor in maintaining the health of periodontium. A very minimal loss of gingiva can at times produce esthetic problems or can be difficult to maintain for the patient. So any periodontal surgical procedure should be directed towards minimal loss of soft tissues. Periodontal procedures conducted with scalpel cause pain, post operative edema, scaring and would lead to soft tissue loss postoperatively. Hence, a tool which can efficiently conduct periodontal surgeries with minimal loss of soft tissue is required. In this facet, a soft tissue diode laser is the most appropriate tool. It can be very conveniently used for frenectomy, gingivectomy, vestibuloplasty, epulis excision, gingival depigmentation and second stage implant surgery. This article emphasizes that a diode laser is a suitable instrument for oral soft tissue surgeries.

Pyogenic granuloma is the non-neoplastic reactive soft tissue growth. It is inflammatory hyperplasia commonly affects the oral cavity. It predominantly occurs in second decade of life and commonly affects the females. It usually has asymptomatic clinical course with rarely causing resorption of underlying bone. Complete excision of lesion is the treatment of choice with removal of local etiological factors. We present a case report of pyogenic granuloma affecting mandibular gingival in 32year old female patient. Total excision of the lesion was done with no reported recurrence following a month follow up. Keywords: Pyogenic granuloma, Epulis, Reactive, Gingiva, Mandible

Focal gingival enlargements are a diverse group of lesions with almost similar clinical presentation but varied etiology and histopathology. The actual cause of peripheral ossifying fibroma (POF) has been debated over many years. POFs are usually seen in childhood and younger ages. There is a slight female predilection. It is usually localized, rarely generalized. Usually, the treatment option is only surgical excision with minimal chances of recurrence. Here, we report a case of POF of the right maxillary posterior region with a review of literature.

The congenital gingival granular cell tumor (CGGT) or congenital epulis is a rare lesion of unknown origin found only in newborn infants. The tumor consists mainly of large eosinophilic granular cells arranged in solid nests that are separated by thin fibrovascular areas. In addition, there are some spindle-shaped cells and medium-sized polygonal cells (so-called interstitial cells) among the neoplastic granular cells. Three CGGTs were investigated with a panel of poly- and monoclonal antibodies, using immunoperoxidase methods on formalin fixed paraffin embedded sections. Neoplastic granular cells of these three cases show cytoplasmic staining for neuron-specific enolase (NSE) and vimentin. However, all other reactions were negative. Our results suggest that the lesion may be derived from uncommitted nerve-related mesenchymal cells. On the other hand, interstitial cells show strong S-100 protein-, cytokeratin-, vimentin-, and NSE-immunostainings, and these cells are consistent with neuroendocrine nature. The presence of a biphasic cell population with granular cells and interstitial cells must be considered the main immunohistochemical feature.

Pyogenic granuloma occurs in the skin and the mucous membranes. The most characteristic features of the lesion are endothelial proliferation and formation of numerous vascular spaces. However criteria to differenciate the lesion from capillary hemangioma or epulis hemangiomatosa has never been established.We examined the histopathological, histochemical and immunohistochemical features in 5 cases of pyogenic granuloma, 6 cases of epulis hemangiomatosa and 2 cases of capillary hemangioma.1) Histopathological study by hematoxylin-eosin staining: In every cases of pyogenic granuoma and 2 out of 6 cases of epulis hemangiomatosa, ulcer formation and superficial inflammation were seen. Every cases of pyogenic granuloma and epulis hemangiomatosa revealed small lobules of proliferated endothelial cells with many vascular spaces in deeper portion of the tumor. These lobules were quite simillar to that of ordinary capillary hemangioma.2) Histochemical study by Ulex europaeus agglutinin I (UEA-I) lectin: UEA-I lectin has been known as the marker for endothelial cell of blood vessel. Endothelial cells in small lobules showed specific and strongly positive reaction to UEA-I lectin.3) Immunohistochemical study by Factor Via related antigen (F VI-RAG): Endothelial cells of lobules revealed no specific reaction to F Via-RAG.In conclusion, it is suggested that pyogenic granuloma and epulis hemangiomatosa are capillary hemangioma with granulation tissue induced by irritations such as repeated trauma or infection.

Epulis is generally classified histopathologically into several subtypes, e. g. epulis fibrosa, epulis granulomatosa, epulis fibromatosa, etc. among them epulis fibrosa and epulis granulomatosa are common in Japan, while epulis with a formation of hard tissue is relatively rare. A case of epulis fibro-osteomatosa cementoplastica is reported.The patient was a 32-year-old female who had noticed a small lump on the gingiva in the left mandibular molar region. Clinical examination revealed a mass of the thumb tip in size in the region between teeth numbered 35 and 37. Radiographic examination showed i cloudy irregular radioopacity in the mass region. The lesion was diagnosed clinically as epulis osteoplastica, and surgical operation was carried out under local anesthesia. On gross examination, the mass was mesured 19 × 13 × 11.5 mm and the/cross section showed a firm milky white mass with scattered areas of hard bony tissue. Histopathological examination was performed and the lesion was diagnosed as epulis fibro-osteomatosa cementoplastica.The postoperative course was uneventful and there is no evidence of recurrence after 6 years.

Peripheral ameloblastoma is a rare tumor of the oral cavity. A case of peripheral ameloblastoma appeared in the lower right mandibular gingiva of a 71-year-old male was presented. The tumor was a semi-spherical mass measuring 25×15×12mm which was clinically diagnosised as a fibroma or an epulis. Histologic examination of the lesion revealed an ameloblastoma of plexiform type. The tumor was excised with a rim of normal tissue. After 18 months, there was no evidence of recurrence. The clinical and histopathologic characteristics, surgical treatment and prognosis of the lesion of 63 cases documented in the literatures concerned were also analysed and summerized.

The primary focus of this experiment was on the investigation of localizations of alpha 1-antitrypsin (alpha 1-AT), alpha 1-antichymotrypsin (alpha 1-ACT), fibronectin (FN) and lysozyme (LY) in tumor cells of experimental malignant fibrous histiocytoma (MFH). The induction of MFH was conducted by injecting Fischer 344 rats with 4-hydroxyaminoquinoline 1-oxide (4-HAQO). In 46 out of 50 rats, tumors were generated, all of which were diagnosed as MFH and classified into 5 subtypes, according to their histological properties. The presence of alpha 1-AT, alpha 1-ACT and FN in all MFH tumor cells was observed in the tumor cells of various types. Especially, fibroblast-like, histiocyte-like and Touton and/or Epulis type giant cells showed strong reactivity. However, positive reaction of LY in MHF tumor cells was very weak, or the reaction was negative. These findings are consistent with those of human MFH.

A case of gigantic epulis of the mandible with pillar-shaped bone formation is reported. The patient was a 37-years-old man. He complained of a slowly growing, painless, tumor protruding from the right molar region of the mandible to the maxilla. The color of the lesion was normal. On palpation, the lesion was elastic hard with an irregular surface, but had a bony hard base. There was bone resorption of the maxilla at regions in direct contact with the tumorous mass. Radiographically, pillar-shaped bone formation was observed in the lesion. The clinical diagnosis was epulis. The epulis was excised with the patient under NLA anesthesia. The excised specimen measured 30×45×40mm. The bone in the lesion was shaped like a pillar and adhered to the mandible. The histopathologic diagnosis was epulis osteoplastica.

d s etastatic tumors represent 1% of the oral malignanies most often originating from the breast, lungs, nd kidneys. Concerning the oral cavity, metastases re usually located in the posterior region of the andible. Metastatic lesions to the oral soft tissues nd gingiva have also been reported. Metastatic tumors to the gingiva are extremely are. Tsianos et al reviewed 14 well-documented ases of gingival metastasis without involvement of he underlying jaw bone and presented another ase of frank malignant metastasis to the gingiva. Of hese cases, 13 were carcinomas and 2 were sarcoas. The maxillary gingiva was involved in 5 cases, he mandibular gingiva in 7, and both of them in 3. he first case of hypernephroma metastasized to he gingiva was reported in 1928 by Branch and orton. Hypernephroma (Grawitz tumor, renal cell carcioma, renal clear cell carcinoma [RCCC]) accounts or more than 90% of kidney malignancies. It is onsidered to be one of the most unpredictable umors, showing an explosive growth and spread, ssociated with either a silent regional growth with o metastases or a metastasis as first evidence in istal organs. In 1883 Grawitz introduced the term ypernephroma, speculating that this tumor originates rom the adrenal crest migrating into the renal paren

Epulis is a benign tumour located in the area of the alveolar bone, periodontal ligament and marginal gingiva. A clinical case of Epulis, treated using an Er,Cr:YSGG laser in our Paediatric Dentistry division of the PTV Hospital, University of Rome Tor Vergata, is described.A pink, sessile, broad-based lesion, elastic in consistency, was detected on the maxillary vestibular gum above the lateral right incisor. The lesion was removed with Er,Cr:YSGG laser (2780 nm) without anaesthetic infiltration, power ranged from 1,5 to 2,0 Watts at 20 Hz repetition rate under 20%-15% air-water spray. The histopathological examination confirmed the diagnosis of fibrous epulis. The immediate postoperative course was excellent, with no pain or need for anti-inflammatory or analgesic drugs. Wound healing was good after 1 week, and was completed after 1 month. The patient was followed up for 3-6 months, and checked again after 1 and 2 years to assess possible relapse. The Er,Cr:YSGG laser has several treatment advantages, fundamental in Paediatric Dentistry: it requires only topical anaesthesia, it has a high clinical safety, there is a short treatment time, no surgical sutures are required; no complications were encountered during or immediately following laser surgery, all resulting in excellent patient cooperation.

A retrospective study was performed to characterize 52 new cases of feline epulides between 1995 and 2001, with clinical and pathological results classified according to Head's histopathologic criteria for canine epulides. The incidence of the fibromatous, acanthomatous, ossifying, and giant cell epulis were respectively 57.7% (30/52), 7.7% (4/52), 5.8% (3/52), and 28.8% (15/52). Giant cell epulides presented significant differences in clinical behavior compared with the fibromatous type, including rapid growth ( P < .0001), presence of ulcerative changes ( P < .01), and rapid recurrence after surgery ( P < .01) from which euthanasia was judged necessary in 4 cases. Fifteen giant cell epulides were additionally examined in order to characterize the lesion both histochemically and immunohistochemically and to investigate the origin of the multinucleated giant cells (MGCs). Van Gieson staining showed osteoid and woven bone formation in 11 cases. Both the MGCs and a fraction of the mononuclear cells were positive for vimentin, tartrate-resistant acid phosphatase (TRAP), a commonly accepted marker for osteoclasts, and the polyclonal antibody receptor activator of nuclear factor κβ (RANK), a cytokine leading to the differentiation of osteoclast progenitors into mature osteoclasts in presence of its ligand. MGCs were negative for smooth muscle actin, MIB-1, and factor VIII. The giant cell epulis may be a variant of the fibromatous and ossifying epulis in which extensive ulceration and inflammation results in increased osteoclastic activity. The osteoclast-like giant cells are most likely formed from a monocyte/ macrophage-like osteoclast precursor that differentiates into osteoclasts under the influence of mononuclear osteoblast-like stromal cells.

techniques. PCR using HPV type-specific primers was done in HPV positive samples. Results: Twenty of the samples (16.9%) were positive in HPV consensus primer detection. Eighteen (23.1%) of the 78 denture wearing patients were positive and two (5.0%) of the 40 non-denture wearing patients were positive. The difference was statistically significant (p1⁄40.01) by fisher test. The most frequent type of HPV of the 14 positive samples was HPV-16. Conclusions: The results suggest that the hyperplastic epithelium of denture epulis may be a reservoir for HPV infection.

The case of a giant-cell epulis as an initial feature of primary hyperparathyroidism is presented. A 58-year-old woman appeared for dental treatment with a buccal alveolar swelling that was confirmed by means of biopsies to be a multinucleated giant-cell lesion. High calcium levels warranted investigation for a parathyroid adenoma, which was located in an ectopic position and surgically removed. This case delineates the importance of referring patients with oral lesions of doubtful cause to specialists for further diagnostic workup.

Congenital granular epulis is a benign tumor that has rarely been diagnosed prenatally, although there have been numerous reports on its postnatal diagnosis. We report a case of large granular epulis diagnosed at 31 weeks' gestation in a woman whose previous anomaly scan had been normal. The lesion was 2.5 cm in diameter, pedunculated, and arose from the maxilla. It was completely surgically removed following preterm vaginal birth and histologically examined. The tumor did not prevent deglutition of the amniotic fluid and did not interfere with feeding or respiration, but prevented complete closure of the lips. We discuss the fetal management and the theories of histogenesis, and highlight the importance of early diagnosis and treatment.

Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular tumor of the skin and mucous membranes. Whereas the literature describes pyogenic granulomas of pregnancy as occurring mainly within the gingival or oral mucosa, we present 5 cases of a histologically confirmed pyogenic granuloma on the hands of gravid women, each with no history of antecedent trauma. These tumors failed to resolve spontaneously postpartum necessitating surgical removal. We propose the term epulis gravidarum manum to describe this skin lesion.

Epulis is the generic and clinical term for tumor-like masses on the gingiva, including hyperplastic as well as neoplastic lesions. Fibrous epulis is uncommon in horses, and its rarity has induced us to write this case report.A 18-year-old Italian saddle horse gelding was referred for examination and surgical treatment of an intraoral peduncolated mass of 5 cm in diameter, located in the mucosa in the vestibular portion of the incisor bone of the upper jaw. The radiographic examination excluded any bone involvement. Six months after surgical removal, there was no recurrency development. The mass was firm, smooth and grey-pink in colour and connected to the gingiva with a peduncle of fibrous tissue. Histologically, an intact multilayered squamous epithelium bordered well vascularized fibrous connective tissue with only a few foci of inflammatory cells. Squamous epithelium formed long fronds originatig from the surface, which assumed a net shape if trasversally sectioned. The mass showed moderately dense cellularity represented by small stellate to spindle-shaped fibroblasts, regularly disposed in a dense fibrillar collagen background. No deposition of either collagen or bone matrix was seen. Some small blood vessels were spread in the stroma. The above reported inflammatory foci showed typical features of chronic inflammation, with lymphoid cells but no granulocytes.The discrete mass here described can be defined as localized gingival hyperplasia or fibrous epulis for its features, i.e. mature fibrous tissue accompanied by chronic-active inflammatory reaction.

We report a case of peripheral odontogenic fibroma arising in the mandible.A 26-year-old Japanese woman visited our hospital because of gingival swelling in the right premolar region of the mandible.The diagnosis was epulis, and the lesion was extracted. The pathological diagnosis was peripheral odontogenic fibroma. This may be the llth case reported in Japan.

Congenital epulis is a well-known lesion that occurs almost exclusively along the alveolar ridge of the maxilla in newborns. A microscopic finding of the ordinary type is similar to that of granular cell tumor that consists of polygonal cells with abundant granular cytoplasm. The histologic variants have been described as congenital leiomyomatous epulis or leiomyomatous hamartoma. Although the exact etiology still remains unknown, they are generally accepted as hamartomatous lesions. Most hamartomas occur as an isolated abnormality, but some may be seen with other developmental defects such as lobulated tongue or cleft lip and palate. In this article, we report a rare case of palatal hamartoma with corpus callosum agenesis, microphthalmia, and malformation of the skin. The pathologic findings and association with other developmental anomalies are unique.

This study reports seven cases of epilus excised by the CO2 laser without anesthesia. The laser was used in a continuous wave mode at power setting of 2–4 W. All lesions were excised completely, and no patients felt pain during laser irradiation. The operation was successful without using surgical packs, and there was no postoperative discomfort. There has been no evidence of recurrence after operation.

Ameloblastoma, especially peripheral ameloblastoma, which arises in oral soft tissue and usually develops extraosseously, is a very rare odontogenic tumor. We describe a case of ameloblastoma that originated in the anterior mandible and persisted for 15 years. The case was in a 61-year-old man, who presented with a 22× 18× 10 mm tumor on the lingual surface of the anterior mandible. Radiographic examination revealed no intraosseous destruction of the mandible. The preoperative clinical diagnosis was an epulis, and the tumor was resected under local anesthesia. The resected tumor was histologically diagnosed to be a peripheral ameloblastoma. Histologically, cord-like or meshwork-like nests of tumor cells were observed below the epithelium. Distinct continuity was noted between the epithelium and the nests. Histologically, the tumor basically showed a plexiform pattern, but an acanthomatous pattern was also noted frequently. There have been no signs of relapse as of two years after operation.

Epulis of the newborn is a granular cell tumour that originates from the dental alveolar mucosa. We report a case of a neonate with multiple congenital masses of the alveolar mucosa who presented for surgery with a potential airway problem. Intubation was achieved uneventfully using a gaseous induction with a large facemask and displacement of the epulides to allow cautious laryngoscopy.

Purpose Amelanotic oral malignant melanoma (AOMM) is a rare tumor that is difficult to diagnose. We studied the clinical and pathologic features of nine cases of this tumor to define diagnostic criteria and estimate prognoses for 2 different types of AOMM. Patients and methods Nine patients with 2 different types of primary AOMM were examined between 1970 and 2002. The histopathology of surgical specimens was studied, uncertain diagnoses were supported by immunohistochemical reactions, and electron microscopy and prognoses were reviewed retrospectively. Results AOMM without radial growth phase may be particularly difficult to diagnose correctly without immunohistochemical assistance. Tumors consisted of a mixture of polygonal and spindle cells in different ratios in tumors with and without radial growth phase. The life span ranged from 3 months to 6 years 3 months, and all 9 patients died of the tumor. In 7 of the 9 cases, distant metastases were found. Conclusions AOMM without radial growth phase may be misdiagnosed as epulis or squamous cell carcinoma. Questionable lesions, particularly maxillary and palatal lesions, must be biopsied for histopathologic and possibly immunohistochemical examinations followed by rapid treatment. The prognosis of AOMM was poor.

Es ging bei dieser Studie darum, eine alternative chirurgische Methode zur Entfernung von Epulis vorzustellen, bei der mukogingivale Komplex insgesamt erhalten und verbessert wird. Nach der Zahnsteinentfernung und Wurzelglattung erhielten sechs Patienten eine chirurgische Behandlung zur Entfernung der Wucherungen. Ein subepitheliales Bindegewebstrnsplantat wurde mit einem gestielten Lappen zwischen Knochen und Epulis eingefugt. Die Lasion wurde nicht chirurgisch entfernt. Die Epulis verschwand nach mehreren Monaten, wobei die Heilungszeit bei den einzelnen Patienten geringfugige Untershiede aufwies. Bei den Kontrolluntersuchungen nach 60 Monaten wiesen alle Patienten eine gesunde Gingiva auf und hatten keine Ruckfalle.

Epulis je benigna promjena na gingivi koja vanjskim izgledom djeluje kao tumor, a po histološkoj slici više odgovara prijelaznim oblicima upalnoga procesa. Pojavljuje se u nekoliko histoloških slika: Epulis gigantocellularis, Epulis granulomatosa, Epulis fibromatosa, kongenitalni epulis, Epulis gravidarum, Epulis haemangiomatosa, Epulis fissuratum, papilarna hiperplazija, piogeni granulom i iritacijski fibrom. Epulis se pojavljuje dvostruko češće u žena nego u muškaraca, nešto češće se javlja u gornjoj čeljusti, a podudarnost kliničke i patohistološke dijagnoze je 48%. Obrađene su kliničke i patohistološke dijagnoze u razdoblju od šest godina da bi se dobio uvid u zastupljenost epulisa kao opisnoga termina među kliničkim dijagnozama. Takvo sabiranje različitih procesa pod jedno ime, koje je nastalo na temelju lokalizacije, bez histopatološke provjere ne daje pravu sliku u kojem se postotku javlja u kliničkoj praksi. Za razlikovanje epulisa od drugih sličnih stanja na gingivi kao najvažnija metoda rabi se patohistološka raščlamba. Važnost epulisa je u tome što je to razmjerno česta tvorba pod čijom sličnom kliničkom slikom može biti različita histopatološka građa i upravo provjerom te građe od patologa kirurg dobiva i opravdanje za operativni zahvat. Iz navedenoga slijedi da bi ponovno uvođenje preciznoga nazivlja patoloških promjena i njihovo jasno patohistološko obrađivanje uvelike pridonijelo da se donese ispravna dijagnoza, a time i primijeni odgovarajuća terapija., Epulis is a benign lesion on the gingiva whose external appearance resembles a tumour, while histologically it looks more like a transitional form of an inflammatory process. It occurs in several histological forms: Epulis gigantocellularis, Epulis granulomatosa, Epulis fibromatosa, congenital epulis, epulis gravidarum, Epulis haemangiomatosa, Epulis fissuratum, papilarna hyperplasia, piogeno granulom and irritative fibroma. Epulis occurs twice as often in women than in men, and slightly more frequently in the upper jaw, and conformity of clinical and histopathological diagnoses is 48%. Clinical and histopathological diagnoses were analysed during a period of six years in order to obtain insight into the frequency of epulis as the described term among the clinical diagnoses. Such a collection of different processes under one name, which emerged on the basis of localisation, without histopathological confirmation, does not offer the correct information on the percentage in which it occurs in clinical practice. Histopathological analysis is used as the most important method for differentiating epulis from other similar conditions on the gingiva. The importance of epulis is that it is a relatively frequent formation, under whose similar clinical appearance can be different histopathological material, and verification of this material on the part of the pathologist, provides the surgeon with justification for performing the operation. From the foregoing it follows that the introduction of precise terms for such pathological lesions and their correct histopathological analysis would greatly contribute to correct diagnosis, and consequently the application of appropriate therapy.

We present a case of a relatively large epulis osteoplastica (epulis osteomatosa), suspected of being a malignant tumor on initial examination, in the mandibular molar region.The patient was a 26-year-old man with a painless mass in his left mandibular gingiva. He had first noticed the mass more than 10 years previously. On initial examination, an eggsized mass was found in the left lower molar region, and x-ray examination revealed calcification in the form of a radiopaque shadow. Various examinations, including biopsy, revealed no evidence of malignancy, and the mass was resected under general anesthesia. The lesion measured 65×50×45mm. Histopathologic examination revealed fairly calcified, chondroid tissue and irregular bone tissue in the mass, and lamination was found at its base. On the basis of these three findings, a diagnosis of epulis osteoplastica (epulis osteomatosa) was made.

The hard laser is now widely used in the oral and maxillofacial region because itshemostatic ability and imploved visualization of the operative field facilitate a presice op-eration. Another important advantage of the hard laser is that some operations can be donewithout anesthesia. In this paper, six cases of epulis excised by the hard laser without anes-thesiaare presented.A CO2 laser (one type of hard laser) was used with a continuous wave, power setting of 2 to 4 watts. All lesions could be excised completely, and no patients felt pain during laserirradiation. The operation was successful without using surgical packs, and there was nopostoperative discomfort. There has been no evidence of recurrence after operation.

Congenital epulis is a rare benign tumour arising from the gum of neonates. We report the antenatal diagnosis and neonatal surgical treatment of a large congenital epulis of the mandible associat

The term “epulis” is applied to any lump arising from the gingiva. Epulides are localized gingival swellings and rarely true neoplasms, metastatic carcinomas or other tumours.

Neurofibroma which is often multiple is one of the symptoms of von Recklinghausen's disease. Solitary development of neurofibroma in the oral cavity is rare. We encountered a patient with a solitary neurofibroma that occurred on the gingiva. The patient was a girl aged one year and one month. She was introduced to our department due to swelling of the upper median gingiva. A swelling was detected in the cervical gingiva labially to the left upper deciduous central incisor. It was smooth on the surface, semi-spherical and elastic, and measured 5 mm in diameter. The swelling was clinically diagnosed as an epulis and was surgically excised under general anesthesia two months later. The resected lesion was spherical and not clearly encapsulated. Hyperplasia of small, thin collagen fibers mixed with fibroblasts was histologically found. The lesion seemed to be neurogenic. It reacted positively to immunohistochemical staining with S-100 protein.

An extremely enlarged epulis is reported. The patient was a 37-year old female. She complained of a slowly growing painless tumor on the left side of the upper jaw. This tumor was excised under general anesthesia and measured 80×85×45mm. The histopathologic features indicated epulis fibrosa.

A mucous cyst (mucocele, mucous retention cyst, ranula, and epulis) is usually a painless, thin sac on the inner surface of the lips. It contains clear fluid. It is painless but can be bothersome. The cyst is thought to be caused due to sucking of the lip membranes between the teeth. A mucous cyst is common and harmless. However, if left untreated, it can organize and form a permanent bump on the inner surface of the lip. A mucous cyst is called ranula when it occurs on the floor of the mouth and epulis when it occurs on the gums. The sac may also be formed around the jewellery (piercings) that has been inserted into the lips or the tongue. This article highlights the use of lasers in the treatment of the excision of mucocele.

The peripheral ossifying fibroma (POF) is a relatively uncommon, reactive gingival overgrowth usually composed of cellular fibroblastic tissue containing one or more mineralized tissues, namely bone, cementum-like material, or dystrophic calcification. The aetiology and pathogenesis of POF are yet not clear, but some authors have hypothesized a reaction originating from the periodontal ligament, as a result of irritating agents such as dental calculus, plaque, orthodontic appliances, and ill-fitting restorations. The aim of our study was to report the clinicopathologic features of a case series of POF from a single Italian institution. A total of 27 cases were collected over an 18-year period. Detailed relevant medical history, clinical and histological information were recorded for each patient. The age range of patients (m = 6; f = 21) was 17.2-80.1 years with a mean of 42.9 ± 18.1 years. Occurrence of the lesion in the mandibular and maxillary arches was similar, and 67.0% occurred in the incisor-cuspid region. The lesions ranged in size from 0.3 to 5.0 cm (mean, 1.3 cm ± 1.1 cm). All the different types of mineralization were present, with higher prevalence of lamellar bone. The lesions were treated by surgical excision and four lesions in three patients recurred after surgery. Surgeons should consider the high recurrence rate of POF and remove the lesion down to the bone involving also the adjacent periosteum and the periodontal ligament. Professional prophylaxis should precede any surgical procedure, and periodical dental hygiene recalls are important in order to remove any possible irritating factor.

Congenital epulis, a benign tumor of the oral cavity, is an extremely rare condition in newborn. It may lead to mechanical obstruction, therefore resulting in respiratory distress and difficulty in feeding. Addressing the problem may need a multidisciplinary team approach at the time of birth. Antenatal ultrasonography and perinatal magnetic resonance imaging are an adjunct to treatment planning. Prenatal diagnosis remains difficult as the findings are nonspecific due to the late development of the tumor. Surgical excision is, therefore, the treatment of choice. Our report discusses this condition and the treatment thereafter on a newborn, with an epulis originating from the upper alveolar ridge discovered at birth. Histological examination confirmed the diagnosis of large polygonal granular cells. The mass was excised under general anesthesia, and the outcome was good after surgery allowing regular feeds on the second postoperative day.

Congenital epulis is an uncommon benign tumor that originates from the alveolar ridge in newborns. It is also known as congenital gingival granular cell tumor. Although there have been around 200 reports of its postnatal diagnosis, this oral tumor has rarely been diagnosed prenatally. We present fetal MRI and Doppler prenatal imaging of an infant with two congenital epulides (simultaneous involvement of superior and inferior maxillas).

Objective To describe a multidisciplinary approach for delivery room management of congenital epulis. Study Design Case reports. Methods Reporting of two cases of congenital epulis and review of the literature. Results Antepartum ultrasonography demonstrated massive intraoral masses in two fetuses whereby concerns regarding the patency of the airway at birth necessitated development of a multidisciplinary team of maternal–fetal medicine, neonatal–perinatal medicine, anesthesiology, and otolaryngology. Surgical excision was performed before delivery in one infant and after complete delivery in the other without a need for endotracheal intubation and general anesthesia. Feeding was started early, and both infants were discharged after brief hospital stays. Pathological findings were consistent with congenital epulis. Differential diagnosis and options for surgical intervention are discussed, including ex utero intrapartum treatment. Conclusions A multidisciplinary approach to antenatally identified congenital intraoral masses facilitates care at birth. Surgical treatment in this milieu may be simple and complete at the time of delivery.