HYPERPLASIA AND RELATED DISORDER RELATED TO ORAL MUCOSA

By:Dr. Mo’ad A. Albdour

hyperplasia

Localized hyperplastic lesion of the oral mucosa: Epulides;

A) fibrous epulisB) pregnancy epulisC) peipheral giant cell granuloma

Pyogenic granuloma Fibroepithelial polyp Denture irritation hyperplasia Papillary hyperplasia of the palate

Epulides Common, localized tumour-like gingival enlargment. Mostly arise from interdental tissue. Trauma & chronic irritation (e.g subgingival plaque) are

the main aetiological factors. F > M 80% occur anterior to molar teeth. Maxilla > Mandible.

A) Fibrous epulis • Most common, present as pedunculated mass, firm of

consistency, with similar colour to adjacent gingiva.• Mostly arise btween 11 – 40 years of age.

B) Pregnancy epulis “vascular epulides”

• Present as soft, deep reddish-purple swelling, extensively ulcerated.

• Haemorrhage occur spontaneously or in minor trauma.• Arise any time of pregnancy with onset usually around the

end of the first trimester.• After delivery may regress spontaneously.

C) Peripheral giant cell granuloma• Least common.• Present as pedunculated drak-

red in colour commonly ulcerated.• Peak incidence in males is the 2nd

decade, while in female is the 5th decade.

• Arise anywhere on gingival or alveolar mucosa.

• Mandible > Maxilla.

Pyogenic granuloma Arise on gingiva, tongue,

buccal and labial mucosa. Initiated by trauma or irritation. Hyperplastic granulation

tissue. treatment include; Excision to

periosteum or periodontal membrane.

May be recur but no malignant potential.

Fibroepithelial polyp Arise manily in cheeks ( along the occlusal line), lips,

tongue. Present as firm, pink, painless swellling from few

millimeters to centimeters in diameter.

Leaf fibroma: a fibroepithelial polyp occurs in the palate under denture, occaionally the surface is whitish due to frictional keratosis.

Denture irritation hyperplasia Related to the periphery of an

ill fitting denture. Single or multiple. Present as firm leaf-like folds of

tissue embracing the over extending flange of denture.

Arise in the depth of vestibular and lingual sulci but may involve the inner surface of lips, cheeks, palate ( along posterior edge of upper denture).

More in the lower denture. F > M

Papillary hyperplasia of palate Aetiology not fully

understood, on the other hand; poor denture hygiene / trauma related to rocking of ill fitting denture / sleping with dentures / candida associated denture stomatitis paly a significant role.

Present clinically as numerous, small, tightly packed papillary projections over part or all denture bearing area.