Kumar D, et al., (2015) Diode Laser Assisted Management of Massive Fibromatous Vestibulum Fissuratum: Current Treatment Perspective., J Translational Clin Case Rep Fam Physician. 01(1), 1-5.
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http://scidoc.org/JBR-TCFP.php
Diode Laser Assisted Management of Massive Fibromatous Vestibulum Fissuratum:
Current Treatment Perspective
Case Report
Kumar D
1*
, Soni BW
2
, Bhandari S
3
, Kumar V
4
, Rattan V
5
1
Ex- Senior Resident, Oral and Maxillofacial Surgery, PGIMER, Chandigarh, India.
2
Senior Resident, Prosthodontics, PGIMER, Chandigarh, India.
3
Assistant Professor, Prosthodontics, PGIMER, Chandigarh, India.
4
Junior Resident, Oral and Maxillofacial Surgery, PGIMER, Chandigarh, India.
5
Head and Professor, Oral and Maxillofacial Surgery, PGIMER, Chandigarh, India.
*Corresponding Author:
Dr. Dinesh Kumar MDS,
Ex-Senior Resident, Oral and Maxillofacial Surgery, PGIMER, Chandi-
garh, India.
Tel: +91 9855995525
E-mail: dr_dinesh78@yahoo.com
Recieved: October 15, 2015
Accepted: October 26, 2015
Published: November 03, 2015
Citation: Kumar D, et al., (2015) Diode Laser Assisted Management of
Massive Fibromatous Vestibulum Fissuratum: Current Treatment Per-
spective., J Translational Clin Case Rep Fam Physician. 01(1), 1-5.
Copyright: Kumar D
©
2015. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution and reproduction in any medium,
provided the original author and source are credited.
Introduction
Hyperplasia refers to the tissue growth into the oral cavity, located
over the alveolar ridges or the soft tissues of the vestibular sulcus.
The gingival mucosa is most venerable to such hyperplasia as it is
exposed to constant irritation. There are numerous irritating fac-
tors that result in such reactive lesions such as ill itting prosthe-
ses, inadequate chewing forces, entrapment of food debris, dental
calculus, or other iatrogenic factors. Gingival tissue can react to
these irritating factors by developing a lesion commonly known as
epulis in dental practice [1, 2].
Epulis issuratum is an inlammatory ibrous hyperplasia located
over the soft tissues of the vestibular sulcus caused by the chronic
irritation from poorly adapted dentures [Figure 1] [3]. Clinically,
this adaptive lesion presents as a raised sessile lesion in the form
of folds, with a normal coloured mucosa and a smooth surface
[4]. This growth is often split by the edge of the denture, one
part of the lesion lying under the denture and the other part lying
between the lip or cheek and the outer denture surface [Figure 2].
This lesion may extend either on one or both sides of the denture.
The treatment of this kind of mass/tissue includes elimination
of the etiological factors, surgical excision of the hyper-plastic
tissue by surgical scalpel, electrical scalpel or laser followed with
appropriate prosthetic reconstruction [3, 4].
In the current scenario, lasers are the preferred means of execut-
ing soft tissue surgery in the oral cavity. The increased eficiency
of surgical procedure combined with decreased morbidity and
no electrical shortening even in the conductive environment are
some of the reasons for transition towards laser assisted proce-
dures over electrocautery in most of the soft tissue lesions in the
oral cavity.
Here is presented a step by step protocol for the massive maxil-
lary epulis issuratum treatment of a patient with diode laser sur-
gery and prosthetic rehabilitation.
Case Report
A seventy years old male reported in the unit of prosthodontics,
postgraduate institute of medical education and research (PGIM-
ER), Chandigarh, with the chief complaint of ill itting dentures
which he was wearing for past 10 years. Patient had a history of
controlled diabetic mellitus and paralysis since 10 and 7 years re-
spectively. The clinical examination showed partially edentulous
maxillary and mandibular arches with a hyperplastic lesion over
the maxillary alveolar ridge extending to the vestibular sulcus in
maxillary anterior region. His overall oral hygiene status was poor.
Abstract
The aim of this study was to present a case report of surgical removal of hyperplasia in the oral cavity using diode laser
radiation and rehabilitation with a complete denture. Epulis issuratum is a pseudotumor growth located over the soft tissue
of the vestibular sulcus caused by the chronic irritation from the poorly adapted dentures. The case discussed in the pre-
sent study reported with the massive ibrous mass (5x2x1 cm) with multiple folds located in the maxillary vestibular sulcus
extending bilaterally from canine to canine region. This massive lesion was excised using diode laser and new complete
dentures with proper peripheral extensions were fabricated and delivered to the patient. Patient was kept on regular follow
up and clinical examination revealed normal vestibular mucosa and functionally suficient prosthesis.
Keywords: Epulis Fissuratum; Diode Laser; Hyperplastic; Ill Fitting Dentures.
JBR Journal of Translational Clinical Case Reports and Family Physician (JBR-TCFP)