Epulis

Epulis
Classification and external resources
Specialty	gastroenterology
ICD-10	K06.8
ICD-9-CM	523.8
DiseasesDB	4410
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Epulis (plural epulides) is any tumor like enlargement (i.e. lump) situated on the gingival or alveolar mucosa. The word literally means "on the gingiva", and describes only the location of the mass and has no further implications on the nature of the lesion. There are three types: fibromatous, ossifying and acanthomatous. The related term parulis (commonly called a gumboil) refers to a mass of inflamed granulation tissue at the opening of a draining sinus on the alveolus over (or near to) the root of an infected tooth. Another closely related term is gingival enlargement, which tends to be used where the enlargement is more generalized over the whole gingiva rather than a localized mass.

This is a fibrous hyperplasia of excess connective tissue folds that takes place in reaction to chronic trauma from an ill fitting denture. It usually occurs in the mandibular labial sulcus. Sometimes the term epulis is used synonymously with epulis fissuratum, but this is technically incorrect as several other lesions could be described as epulides.

This type of epulis is neither pyogenic ("pus producing") nor a true granuloma, but it is a vascular lesion. About 75% of all pyogenic granulomas occur on the gingiva, although they may also occur elsewhere in the mouth or other parts of the body (where the term epulis is inappropriate). This common oral lesion is thought to be a reaction to irritation of the tissues and poor oral hygiene. It is more common in younger people and in females, and appears as a red-purple swelling and bleeds easily.

Also termed a "pregnancy tumor" or "granuloma gravidarum", this lesion is identical to a pyogenic granuloma in all respects apart from the fact that it occurs exclusively in pregnant females. There is usually pregnancy gingivitis also. Pregnancy epulis commonly occurs during the third trimester of pregnancy.

This epulis most commonly occurs on the gingiva near the front of the mouth between two teeth. It may be sessile or pedunculated and is composed of fibrosed granulation tissue. Fibrous epulides are firm and rubbery, and pale pink in color. Over time, bone may form within the lesion at which point the term peripheral ossifying fibroma may be used (in some parts of the world).

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