Multidisciplinary treatment of epulis fissuratum: A case report

Epulis fissuratum is an inflammatory fibrous hyperplasia characterized by pseudotumoral growth in the soft tissues of the oral mucosa. It is a multifactorial condition caused by factors such as poor oral hygiene, prolonged use of ill-fitting dentures, continuous use of dentures without intervals of rest, and underlying systemic conditions such as diabetes mellitus and coagulation disorders. Although initially asymptomatic if left untreated, the lesion may result in complications such as ulcerations, secondary infections, and interference with speech, masticatory function, and oral aesthetics with significant adverse impact on the patient.

A 56-year-old female patient with no significant medical history presented to the dental clinic with tissue overgrowth and depression of the upper lip. She reported 30 years of continuous use of a complete maxillary denture without ever removing it. The management of this condition required a multidisciplinary approach to ensure accurate diagnosis and a strategic treatment plan tailored to her systemic health and the severity of the oral condition. The diagnosis of epulis fissuratum was confirmed through histopathological analysis. Treatment was implemented in two phases: Surgical and prosthetic. The surgical phase involved excision of the excess tissue and placement of a free gingival graft in the anterior maxillary vestibular area in order to deepen the vestibule and optimize the ridge for prosthetic rehabilitation. The prosthetic phase involved fabrication and placement of a new complete denture.

The multidisciplinary management of epulis fissuratum resulted in precise clinical diagnosis, effective soft tissue management, and appropriate prosthetic adjustments, thereby ensuring favorable long-term outcomes for the patient.