[In situ penicillin therapy in the treatment of epulis]

An epulis is a hyperplastic tumor of the oral mucosa. The pathophysiology of epulis is unclear. Standard treatment consists of surgical excision but in situ penicillin therapy was recently proposed. In situ treatment consists of injecting 1,000,000 IU of penicillin G into the tumor every three days until complete disappearance is obtained. Absence of allergy to penicillin must be ascertained prior to treatment. The purpose of this report is to describe results in 5 patients presenting different histological forms of epulis treated by in situ penicillin therapy at the Dental Care Center of Rabat, Morocco. Complete disappearance of the tumor was achieved after 3 to 5 injections in all 5 patients. In 4 patients the tumor first necrotized and then fell off. In the remaining patient, the tumor regressed gradually. No complications were observed and no recurrence has been noted with follow-up ranging from 24 to 30 months. Since in situ penicillin therapy is more cosmetic, easier to perform, and less expensive than surgical excision, it should be included in the arsenal of therapeutic modalities for management of epulis.