Fibrous epulis associated with impacted lower right third molar

• Main Authors: Ni Putu Mira Sumarta, David B Kamadjaja
• Format: Article
• Language: English
• Published: Universitas Airlangga 2009-12-01
• Series: Dental Journal: Majalah Kedokteran Gigi
• Subjects: epulis; fibrous epulis; excision; impacted molar
• Online Access: http://e-journal.unair.ac.id/index.php/MKG/article/view/937
• ISSN: 1978-3728; 2442-9740

<span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Epulis or epulides are lesions associated with gingival tissues. Fibrous epulis is a type of hyperplastic fibrous </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>tissue mass located at the gingival which is slow growing, painless, having same color as the oral mucosa and firm on palpation. </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Anterior regions of the oral cavity are the frequently affected sites as these areas are more prone to be affected by calculus deposition </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and poor plaque control due to frequent teeth malposition. Removal of any irritating factors and excision of the lesion are the usual </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>treatments. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>This case report presents a rare case of fibrous epulis which occurred in the posterior region of the oral cavity </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and associated with impacted lower third molar. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>A case of fibrous epulis at the lower right third molar area of three months </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>duration is presented. The mass was slow growing, painless and on examination it was a pedunculated mass overlying the unerupted </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>lower right third molar, having same color with the oral mucosa and firm on palpation. Clinically, the lesion was diagnosed as fibrous </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>epulis associated with impacted lower right third molar. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case management: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>The treatment were surgical excision of the epulis and </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>removal of the lower right third molar. The histopathology result showed tissue with squamous epithelial lining, achanthotic fibrous </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>connective tissue, mononuclear inflammatory cells and few capillaries without signs of malignancy. This is consistent with the diagnosis </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of fibrous epulis. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Fibrous epulis, although frequently occurred at the anterior region of the oral cavity, may rarely grow </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>at the area of lower third molar. This phenomenon supports the theory that epulis can grow on any surface of oral mucous membrane </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>as long as local irritants are present.</em></span></span></span></span></span></span></span></span></span></span></span></span></span><br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" /></span></span></span></span></span></span></span></span></span></span>