Epulis:

👉 Epulis means “upon the gum”. It refers to a solid swelling situated on the gingiva.

👉 It arises from the alveolar margin of the jaw.

👉 The swelling is usually painless.

Classification of Epulis ➡️ Based on it’s consistency:

⚫ Soft Epulis – Granulomatous

⚫ Firm Epulis – Fibrous, Giant cell

⚫ Hard Epulis – Carcinomatous

⚫ Malignant Epulis – Carcinomatous

⚫ Dangerous Epulis – Fibrosarcomatous

Granulomatous Epulis:

🔼 Consistency: Soft to firm fleshy mass

🔼 Clinical Presentation: Manifests as a mass of granulation tissue around the teeth on the gums. It bleeds on touch.

🔼 Example: Pregnancy Epulis (gingivitis gravidarum)

Fibrous Epulis: (⭐ most common)

🔼 Consistency: Firm polypoidal mass

🔼 Clinical Presentation: Slow growing, non tender, a simple fibroma arising from the periodontal membrane, presents on the gum. May undergo sarcomatous change.

Giant Cell Epulis: (⭐ AKA Myeloid Epulis)

🔼 Consistency: Soft to firm gums with indurated underlying mass due to expansion of bone.

🔼 Clinical Presentation: It is an osteoclastoma arising in the jaw. Presents as hyperaemic vascular, oedematous, may ulcerate and result in haemorrhage. X ray shows pseudo trabeculation.

🔼 Treatment: Small tumours are treated by currettage; Large tumours are treated by radical excision.

Carcinomatous Epulis:

🔼 Consistency: Hard or malignant in consistency.

🔼 Clinical Presentation: This is an epithelioma arising from mucous membrane of the alveolar margin. Presents as a non healing, painless ulcer slowly infiltrating the bone. Hard regional lymph nodes are due to metastasis.

🔼 Treatment: Wide excision which includes removal of segment of the bone.

SOURCE: Manipal Manual of Surgery (3rd edition)

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~Sunantha✍️