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Keywords
Epulis granulomatosa, extraction socket, granulation tissue
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.
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 softtissues 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 cm × 1.5 cm in the region of 31 which was erythematous and smooth surfaced. The lesion was sessile, firm in consistency, non-tender, non-pulsatile, and no blanching was observed on palpation. There was severe bleeding when the lesion was probed. Intraoral periapical radiograph showed...