EPULIS FISSURATUM

Epulis fissuratum is a mucosal hyperplasia that results from chronic low-grade trauma induced by a denture.

Epulis fissuratum is analogous to acanthoma fissuratum of skin

CAUSES

 The cause of epulis fissuratum is chronic low-grade irritation from an ill-fitting denture. Frequently, this is the consequence of resorption of the alveolar ridge so that the denture moves further into the vestibular mucosa, creating an inflammatory fibrous hyperplasia that proliferates over the flanges.

RISK FACTORS:

Race- mostly seen in whites

Sex-more in women than men.

Age-more seen in 5-6 th decades

FEATURES:

• epulis fissuratum patient typically reveals folds of hyperplastic mucosa, which

encompass the border of the denture flange. The edge of the denture usually fits in a groove between the

folds. The lesions are most frequently observed at the facial aspect of the denture. The occurrence of this

on the lingual surface is unusual. They are more often observed in the anterior portion of the jaws;

however, a predilection for the maxilla or the mandible does not seem to exist.

• The surface of the epulis fissuratum mass tends to be smooth; however, occasionally, it is ulcerated (most often within the depth of the groove) or papillary.
• The size of the epulis fissuratum lesion is variable; some lesions are small, but they can be extensive and involve the entire length of the vestibule.
• Although frequently of normal mucosal color, erythema may be associated with inflammation. Some lesions have a more pyogenic granuloma –like appearance because of capillary proliferation.

TREATMENT

Surgical  - Surgically excise the epulis fissuratum because even removal of the offending stimulus (ie, denture) will not result in complete resolution. In addition, correct the denture; otherwise, the lesion will recur. Either make a new denture or reline the old denture. The use of laser therapy is also seen.

HOMOEOPATHIC MANAGEMENT:

• CAL CARB
• NAT MUR
• THUJA
• MER SOL