Documente Academic
Documente Profesional
Documente Cultură
CASE REPORT
Keywords
Epulis granulomatosa, extraction socket,
granulation tissue
Correspondence
Dr. B. Manovijay, 56/66C Gandhi
Nagar, Vellandi Valasu Post, Edappadi,
Salem-637 105, Tamil Nadu, India.
Email:drmanovijaymds@yahoo.com
Received 05 February 2015;
Accepted 10 March 2015
Abstract
Epulis granulomatosa is a benign tumor-like proliferation arising from a poorly healing
extraction socket, a complication as a result of bony spicules or tooth fragments within
the socket. The remnants act as inciting agents to precipitate an inflammatory reaction
to the fibrovascular connective tissue core replacing the defect previously occupied
by the tooth. Recurrence of such lesions is rare as excision eliminate the stimulus for
inflammation suggesting an indefinite underlying pathology. The following is a case
report of recurrent epulis granulomatosa in a 64-year-old patient, detailing the clinical
features, diagnosis, and management with emphasis on the differential diagnosis, both
clinical and histopathological.
doi: 10.15713/ins.jcri.63
Introduction
Epulis granulomatosa is a benign hyperplastic tissue presenting
as an overgrowth arising from a recently extracted tooth socket.
Following a tooth extraction, healthy healing of the socket ensues
by regeneration of hard and soft tissues followed by replacement
of the space by fibrovascular connective tissue. One inadvertent
complication following extraction can lead to hyperplastic
overgrowth arising from the poorly healing extraction socket.[1,2]
The behavior of such lesions, tumor-like appearances, and rapid
rate of growth of the lesion alarm both patients and dentists to
consider a variety of malignant tumors. The following is a case
report detailing the steps in diagnosis and management of such
conditions.
Case Report
A 64-year-old male presented to the private dental clinic with
the complaint of growth in the lower front region of the jaw.
Patient recalls a similar growth arising from the extraction socket
following 2 weeks after extraction of lower central incisor and
the growth was excised. The present growth had occurred in
the same site 11/2 after excision [Figure 1]. On examination,
the lymph nodes were not palpable, and the lesion was seen as a
solitary well-defined nodular growth of size size 1.5 cm1.5cm
140
Manovijay, et al.
Epulis Granulomtosa
Journal of Advanced Clinical & Research Insights Vol. 2:3 May-Jun 2015141
Manovijay, et al.
Epulis Granulomtosa
142
References
1. Leong R, Seng GF. Epulis granulomatosa: Extraction sequellae.
Gen Dent 1998;46:252-5.
2. Benjamin A. Epulishaemangiomatosa - Post extraction sequelae.
Sci J 2009;3:1-3.
3. Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology.
4th ed. Philadelphia: W.B. Saunders; 1983. p. 601-8.
4. Gnepp DR. Diagnostic Surgical Pathology. 4th ed. Philadelphia:
Lippincott Williams; 2004. p. 205.
5. Wood NK, Gauz PW. Differential diagnosis of oral and
maxillofacial lesions. 5th ed. Missouri: Mosby, Elsevier; 1997.
p.142-3.
6. Manjunatha BS, Kumar GS, Raghunath V. Histochemical and
polarization microscopic study of two cases of vegetable/pulse
granuloma. Indian J Dent Res 2008;19:74-7.
7. Khl SR, Schulze RK, Kreft A, dHoedt B. Epulis granulomatosa
as an oral manifestation of Klippel-Trnaunay syndrome. JOral
Pathol Med 2006;35:576-8.
8. Slootweg PJ. Dental Pathology. 1st ed. New York: Springer; 2007.
p. 46.
Journal of Advanced Clinical & Research Insights Vol. 2:3 May-Jun 2015