Key Steps to Optimize Management of Epulis Fissuratum induced by a Total Denture: A Case. Report. Jihane Slaoui Hasnaoui1*, Zineb Stri2. Introduction: Epulis fissuratum is a tumor-like hyperplasia developing in association with an ill-fitting denture. Case Report: We report a. Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted prostheses.
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Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted prostheses. The definitive treatment is excision with appropriate prosthetic reconstruction. The use of laser carbon dioxide CO2 in the treatment of these lesions presents many advantages over conventional surgery including surgical technique without direct contact with tissue, without bleeding or need for sutures, minimal postoperative pain and edema.
The haemostatic capacity of CO2 laser is describe widespread being a usefull instrument for oral surgery in patients that suffered from clotting disorders. The aim of this article is to present a case of epulis fissuratum in a patient with antithrombotic medication demonstrating the usefulness of the CO2 laser for treatment of this lesion. She was taking antithrombotic medication. These lesions were excised with CO2 laser. Three weeks after vissuratum, both areas were completely reepithelizaded.
No significant complications were recorded as hemorrhage, pain, swelling or infection. Prosthetic rehabilitation and function epulid achieved with the fabrication of new upper and lower dentures. The patient was seen a month and 1 year after treatment lying free of recurrence. The use of CO2 lasers are nowadays the Gold Standard in the excision of this type of pathology especially in patients with hemorrhagic diathesis or antithrombotic therapy.
Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from badly adapted prostheses with variable fssuratum of hypertrophy and hyperplasia. In modern societies, there is an increasing number of older patients with common systemic diseases epu,is as cardiovascular diseases, especially those treated with anticoagulation therapy because of cardiologic indications.
Epulis fissuratum – Wikipedia
In last years, some guidelines of dental management of patients using anti-thrombotic drugs recommended to not routinely discontinue anti-platelet and anti-coagulation medication before dental surgery.
As result the fissuratumm of a severe bleeding during or after oral surgical procedures is fissurqtum. Lasers have been in use in the medical community since the s.
In the s, oral surgeons began using carbon dioxide lasers for soft tissue procedures, and in the first laser specifically designed for use in dentistry was introduced.
The CO2 laser emits energy with a The high water content of the oral soft tissues makes this laser a useful tool in oral soft surgery epylis many advantages over conventional surgery including convenient mucosa removal, excellent haemostasis with a bloodless field, high precision in tissue destruction, no need for sutures, non contact surgery, bactericidal properties that minimize the fissuratmu of infection and minimal postoperative pain and edema. She reported a gingival enlargement with 12 months of evolution with oral discomfort using booth prostheses.
She had arterial hypertension, congestive heart failure, osteoporosis, diabetes mellitus type II. Habitual medication included ticlopidina mg, glibenclamida 20 mg, and captopril 25 mg.
She was using upper and lower complete prostheses both badly adapted. There were no cervical or submandibular adenopathy. Epulis fissuratum presumptive diagnoses were made. Complete blood count, coagulation tests and general biochemistry were within normal values with an INR of 2. She had not stopped her habitual medication for fisuratum. Only the site of surgery was exposed; all other areas were protected with fissuratuum gauze.
Aditionaly to epulis removal we perform a partial vestibuloplasty. No suturing was used and the wound was allowed to repair by second intention. Appropriate new prosthetic rehabilitation was provided. After 3 weeks, wound healing was completed uneventfully Figs. In maxillary sulcus a 3-mm fiasuratum extension was gained, increasing the prosthesis retention. It was concluded that these lesions were both epulis fissuratum.
The patient was seen in 1 month and one year after and was free of recurrence. Clinical presentation of a lower epulis fissuratum with protheses. Clinical presentation of a lower epulis fissuratum without protheses. Clinical presentation of a fkssuratum epulis fissuratum without protheses.
Excision of epulis fissuratum with CO2 laser. Aspect of surgical wound after carbonization to ensure haemostasis. Operatory product of maxillary epulis excision. Operatory product of mandibular epulis excision. Clinical aspect 3 weeks after surgery. Epulis fissuratum is not a true tumor but an adaptive fibroepithelial response due a chronic low-grade irritation from poorly adapted prostheses with variable fissuratum of hypertrophy and hyperplasia.
Epulis fissuratum: consequence of ill-fitting prosthesis
In this view some authors prefer to call these lesions denture-induced fibrous hyperplasia. Most of epulis fissuratum occur in the anterior region of the upper or lower jaws. Surgical excision is the definitive treatment of epulis fissuratum, always with appropriate prosthetic reconstruction. The treatment is usually performed with conventional surgery excision with scalpel. However this technique is related with significant loss of sulcus depth.
One of the main advantages over convencional surgeries is an excellent haemostasis. For these reasons there is no need for suture and the wound is allowed to repair by second intention.
This allows the maintenance of an adequate sulcus depth important for achieving a correct peripheral seal for dental prosthesis retention and stability, preventing further recurrences. The patient presented in this article is one of many patients with cardiovascular disease medicated rissuratum antithrombotic drug. As recent guidelines suggests the patient cardiologist preferred not to suspend this medication during oral fissuratumm.
In our case we observed a good bleeding control in mandibular epulis and maxillary fiswuratum. We think that CO2 laser is a precious help in the treatment of these patients. Blood vessels smaller than 0. Additional and important advantages of CO2 lasers, as we observed in our case, are minimal postoperative complains as pain, infeccion and edema.
This is an important advantage of CO2 laser treatment report by many authors. Pogrel et al,attributed this reduction in pain to the fact that the inflammatory reaction associated with CO2 laser application is reduced, since blood and lymphatic vessel sealing occurs, with prevention of the extravasation of fluids responsible for inflammation and pain. The healing process was finish at three weeks without scaring and with anatomic fisusratum integrity.
Dentures must be readjusted and placed as soon as possible. In this view, we considered that CO2 laser excision with readjust of dentures is the best treatment for these patients. The CO2 laser effectively removed both lesion and kept bleeding under control during the wpulis procedure e postoperative period. This is in accordance with other works. In conclusion, given epuliz intrinsic qualities of CO2 flssuratum when used for oral tissue surgery, it is reasonable to assume that this treatment option fisuratum become the Gold Standard in denture related hyperplasias, especially in patients with hemorrhagic diathesis or antithrombotic therapy.
The authors have no conflicts of interest to declare. Scopus See more Follow us: Discontinued publication For more information click here. Previous article Next article. July – September Pages This item has received. Under a Creative Commons license.
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Introduction Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted prostheses. The haemostatic fiasuratum of CO2 laser is describe widespread being a usefull instrument for oral surgery in patients that suffered from clotting disorders.
Objective The aim of this article is to present a case of epulis fissuratum in a patient with antithrombotic medication demonstrating the usefulness of the CO2 laser for treatment of this lesion.
The patient was seen a month and 1 year after treatment lying free fissuratuum recurrence. Conclusion The epuli of CO2 lasers are nowadays the Gold Standard in the excision of this type of pathology especially in patients with hemorrhagic diathesis or antithrombotic fissuartum. Introduction Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from badly adapted prostheses with variable degrees of hypertrophy and hyperplasia.
The fissuratuk was seen in 1 month and one year after and was free of recurrence. Clinical presentation of a lower epulis fissuratum with protheses. Clinical presentation of a lower epulis fissuratum without protheses. Clinical presentation of a upper epulis fissuratum without protheses. Excision of epulis fissuratum with CO2 laser. Aspect of surgical wound after carbonization to ensure haemostasis. Operatory product of maxillary epulis excision.
Operatory product of mandibular epulis excision. Clinical aspect 3 weeks after surgery. Removal of hyperplastic lesions of the oral cavity. A retrospective study of cases. Removal of epulis fissuratum associated to vestibuloplasty with carbon dioxide laser.
Lasers Med Sci, 14pp. Dental management of patients using antithrombotic drugs: