Soft Tissue Lesions
Epulis Fissuratum
aka Denture-Induced Fibrous Hyperplasia · Denture Granuloma · Inflammatory Fibrous Hyperplasia
Hyperplastic fibrous tissue folds in the vestibule caused by ill-fitting denture flanges.
Cause
Ill-fitting denture
Site
Vestibular fold
Rx
Excision + new denture
§ overviewOverview
Reactive tissue overgrowth secondary to chronic irritation from a denture flange.
§ icdICD Classification
K06.1
§ etiologyEtiology
- 01Ill-fitting denture flange
- 02Chronic mechanical irritation
§ epidemiologyEpidemiology
Common in denture wearers, especially elderly.
§ pathogenesisPathogenesis
Chronic low-grade trauma → fibrous tissue proliferation → redundant folds.
§ clinicalClinical Features
- 01Single or multiple soft tissue folds in vestibule
- 02Firm, fibrous consistency
- 03Denture flange sits within groove between folds
- 04Usually painless
§ differentialDifferential Diagnosis
- 01Inflammatory papillary hyperplasia
- 02Fibroma
- 03Peripheral giant cell granuloma
- 04SCC (if ulcerated)
§ histopathHistopathology
- 01Hyperplastic stratified squamous epithelium
- 02Dense fibrous connective tissue with chronic inflammation
§ investigationsInvestigations
- 01Clinical exam + biopsy if atypical
§ treatmentTreatment
- 01Relieve denture flange
- 02Surgical excision of redundant tissue
- 03Reline or new denture
§ complicationsComplications
- 01Recurrence if denture not corrected
§ prognosisPrognosis
Excellent after excision and denture correction.
§ examKey Examination Points
- 01Always assess denture fit
- 02Excise + address cause
- 03No malignant potential but biopsy to exclude SCC
§ revisionQuick Revision Summary
- 01Denture flange irritation
- 02Firm folds in vestibule
- 03Excision + new denture
§ vivaBDS Viva Questions
- 01What causes epulis fissuratum?
- 02How do you manage it?
- 03What would you expect on histology?
§ mcqsMCQs — Assessment (3)
Question 1
Epulis fissuratum is caused by:
Question 2
Treatment includes:
Question 3
Histology shows:
References
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.