Author-Dr Aparna Pandya (Mrs India Vivacious 2019)
Epulis is a growth of the gingiva and develops in response to any irritative factors like tartar, and interdental spaces. Epulis more frequently occurs in women than in men.
The cause of epulis is multifactorial like irritative factors (poor oral hygiene, periodontal conditions) and hormonal changes.
Although epulis is classically categorized into different subtypes, current literature summarized three main types: fibrous epulis, granulomatous epulis, and giant cell epulis. Histopathologically, the lesion consists of hyperplastic connective tissue, can be ulcerated, and covered by stratified epithelium.
The treatment of epulis is to remove the causative factors and surgical excision of the lesion.
Epulis is most common following orthodontic treatment. Its size can be significant. largely vascularized, it bleeds easily. Its treatment excision up to the bone contact, and oral hygiene maintenance. In children, the presence of an epulis requires a complete blood count (CBC) to rule out leukemia.
There are three main cause of epulis. The first is that epulis occurs as a response to original stimulants (unfitting prosthetics, residual roots, poor oral hygiene and trauma). Cells of the mucoperiosteum respond to similar stimulants by forming a specific granulation tissue. Alternate proposition suggests a benign lump. A third proposition holds that hormonal imbalance related to hyperparathyroidism act as the cause of epulis.
Generally, epulis is a reactive hyperplasia of the connective tissue of the gingiva or the periodontal ligament.
No clinical laboratory tests are used for these lesions. A definitive opinion requires excision of the lesion.
Epulis is a recurrent lesion in gingiva without specific treatment for its unexplained pathogenesis. Nowadays, surgical excision is the most popular method of treatment. To prevent recurrence, it is necessary to resect diseased tissues thoroughly and even to remove the involved teeth.
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