An epulis granulomatosa is a granuloma which grows from an extraction socket ( the hole left after a tooth has been. The mouth constitutes a sort of “no man’s land” between the domain of the dermatologist and that of the dentist, and the boundaries of their respective fields a. Epulis granulomatosa involving the lower gum, consisting of a rather firm, cauliflower-like growth and simulating carcinoma. that the lesion might be due to a.
Epulis granulomatosa is a lesion which grows from an extraction socket. It can be misdiagnosed with lesions of the same clinical appearance such as: The most common treatment is surgical eplis. Lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients due to the rapid and regular wound healing without sutures.
There are several oral soft tissue lesions in pediatric patients with different clinical presentations 1. Gingival enlargement is a common finding during clinical examination 2. The etiology and pathogenesis of gingival enlargement are still not well established. Most of the gingival enlargements are inflammatory in origin and therefore can be treated completely with conventional periodontal treatment such as internal bevel gingivectomy.
Because of its unusual clinical granulomatoxa, the diagnosis and treatment plan can be complicated in some cases.
Histopathologic examination is the gold standard for the most reliable diagnosis of these lesions 2.
Excision of Epulis Granulomatosa with Diode Laser in 8 Years Old Boy
Epulis granulomatosa refers to a tissue growth into the oral cavity which is a post-surgical lesion emanating from an extraction socket 3. It can be misdiagnosed with lesions of the same clinical appearance, for example, foreign body or pyogenic granulomas, or as a herniation of the maxillary sinus 2.
There are several techniques for removal of the oral lesions, including: Scalpel, Electro surgery and Laser techniques. The most common treatment is surgical excision 4. The present report concentrates on a case which was treated using diode laser as the child was afraid of traditional surgical blade and bleeding. An 8-year-old boy patient referred to the Pediatric Dentistry Department, Tehran University of Medical Sciences complaining of a gingival mass in the upper right region at the extracted first primary molar granulomtaosa.
There was no history of systemic disease. Oral hygiene was poor and the patient reported history of acute abscess in the upper right primary first molar which was extracted 2 months ago. Figure 1-A, B The lesion was asymptomatic granulomatoss caused some mastication problems. In radiographic examination, the underlying bone was eplis and there was no radiolucency or erosion in epuli bone.
No medication was prescribed for the patient. After 2 weeks, at the follow up session, the site of surgery was completely healed Figure 1-D to 1-F. Ulcerative reddish mass at region of extracted first primary molar C Excisional biopsy with diode laser D, E Site of surgery immediately after operation and F Site of surgery at follow up session 2 weeks after surgery.
In order to make an accurate diagnosis, pathologist was informed that the lesion had been removed by laser. The histological examination revealed connective tissue elements consisting of proliferation of plump fibroblasts and endothelial cells with spindle shape nuclei.
Numerous and various sized blood vessels with extensive infiltration of chronic inflammatory cells, mostly lymphocytes were also evident. Figure 2 In most areas, the overlying non-keratinized stratified squamous epithelium was ulcerated.
In the depth of the specimen, areas of bone trabeculae and osteoid matrix were also visible. Numerous and various size of blood vessels. In most areas the overlying non-keratinized stratified squamous epithelium was ulcerated. Oral surgery in children is often a challenging procedure due to lack of patient cooperation. Several authors have explained that the use of laser in soft and hard tissue surgery causes less discomfort and better tolerance by young patients and their parents 67.
Thus, laser can decrease psychological trauma and panic during the surgical procedure due to reduced surgery time. Recent advances have shown that laser therapy can be used as an alternative or complement to traditional methods 58.
Laser surgery usually requires local anesthesia, but rarely needs sutures. Advantages of laser excision of these lesions are least hemorrhage, lower post-surgical pain and rapid wound healing after surgery 9. Today, diode laser is widely used in oral surgery to excise lesions The relatively small size and lower costs of diode laser have epuljs it interesting to dental practitioners for use in different indications. Benefit of diode laser over traditional surgery with scalpel comprises convenient mucosa removal, high precision in tissue destruction 411easy ablation of soft tissue, immediate sterilization, epuliz mechanical trauma, increased patients acceptance, no or few sutures 8homeostasis, decreased bacteremia, decreased edema, less operative and post-operative discomfort 48little wound contraction and minimal scar 58.
In addition to all the benefits mentioned, laser is very useful in pediatric patients for oral surgical procedures 5.
Epulis – Wikipedia
YAG lasers, the radiation of diode laser shows more absorption and less penetration depth, mainly in blood-rich tissue 12 Diode lasers with wavelengths in the range of nm are available for use in dentistry. All diode wavelengths are strongly absorbed by tissue pigments and penetrate deeply. The application of diode laser can stimulate fibroblast proliferation, collagen synthesis, vessels proliferation accompanied by enhanced epithelial cell division resulting in faster wound healing Diode laser with nm wavelength is significantly absorbed in tissue due to the presence of hemoglobin.
This causes not only better incision, but also very good coagulation of tissues. With laser sterilization of wound; the inflammatory response is mild and delayed. Less discomfort may correspond to the decreased inflammatory reaction related to laser application. Moreover, laser irradiation causes sealing of the nerve endings in the surgical contact area and the granuloamtosa collagen layer formed on the surface of the surgical wound serves to isolate it from the oral fluids 4 Due to the rapid and regular wound healing without sutures, lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients.
Laser technology provides optimal care for children without many of the ‘fear factor’ found in routine dental care and can increase the cooperation grwnulomatosa pediatric patients. J Lasers Med Sci ;6 2: National Center for Biotechnology InformationU. J Lasers Med Sci. Find articles by Nasim Chiniforush. Author information Copyright and License information Disclaimer.
This article has been cited by other articles in Granulkmatosa. Introduction There are several oral soft tissue lesions in pediatric patients with different clinical presentations 1. Case report An 8-year-old boy patient referred to the Pediatric Dentistry Department, Tehran University of Medical Sciences complaining of a gingival mass in the upper right region at the extracted first primary molar area.
Open in a separate window. Conclusion Due granulommatosa the rapid and regular wound healing without sutures, lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients. Notes Please cite this article as follows: Pediatric soft tissue lesions.
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