Integral surgical management of epulis fissuratum using conventional excision and free gingival graft: a case report

Epulis fissuratum (EF) is a benign fibrous hyperplasia of the oral mucosa caused by chronic trauma, usually linked to prolonged use of poorly fitting prostheses. This condition compromises phonation, chewing, and aesthetics, thus affecting quality of life. We report the case of a patient who had worn complete upper dentures for three decades and developed EF. Management required two stages. First, the lesion was excised with a scalpel, obtaining tissue for histopathological confirmation. Three months later, a second surgery was performed with a free gingival graft to deepen the vestibule and create an adequate keratinized gingival band. At three months, follow-up showed proper healing, favourable soft tissue recovery, and no recurrence, enabling future rehabilitation. This case illustrates that sequential management, combining surgical excision and gingival grafting, provides a predictable and reliable alternative for advanced EF, ensuring functional recovery and improved prognosis.