Treatment of Epulis Fissuratum Using an In Situ Harvested Free Gingival Graft: A Case Series and Literature Review

Epulis fissuratum (EF) is a reactive fibrous overgrowth in the oral vestibule caused by chronic denture irritation. We describe two patients (aged 58 and 42 years) in whom EF was excised and vestibuloplasty performed using a free gingival graft (FGG) harvested from the excised lesion itself. In Case 1, a hyperplastic fold of the maxillary anterior alveolar mucosa was removed, the incision apically repositioned, and the thinned, deepithelialized graft immobilized over the periosteum. In Case 2, peri-implant hyperplastic tissue was excised and the graft, prepared using the accordion technique, was positioned around the healing abutments. Case 1 was followed up at 2 and 10 months and Case 2 at 2 months; healing was uneventful in both, with a clinically adequate band of keratinized mucosa and stable vestibular depth at each visit. Within the limitations of this short-follow-up two-case report, using the lesion itself as the graft source provided acceptable keratinized mucosa and vestibular depth. Larger prospective studies with 12-24-month follow-up are warranted.