Localized gingival overgrowth
Gingiva commonly known as the gums. Gingival overgrowth can become swollen either all throughout the upper and lower arches or in only a particular region. When it’s a generalized swelling it’s called gingivitis and when it’s limited to a specific region it’s called an epulis.
An epulis can be due to a variety of causes like
- pyogenic granuloma
- peripheral giant cell granuloma
- gingival abscess
- irritation fibroma
- epulis fissuratum in an edentulous denture wearing patient
- pregnancy epulis
The most common type of epulis is the pyogenic granuloma which is seen most commonly in the front gums region partly obscuring the teeth of that region. It occurs due to physical trauma, oral plaque, and calculus or sometimes due to infection. It appears bloody red and can even bleed during brushing. The treatment is usually surgical removal in toto except for bigger lesions in which we fear excessive blood loss for which we can first inject sclerosing or fibrosing agents and later excise the lesion.
Here is one case of an anterior gingival epulis which was presumed to be a Pyogenic Granuloma. A 45 yr old diabetic patient came to Richardsons dental and craniofacial Hospital with a swelling on her anterior gums which was there for about 6 months and was covering her front teeth. Examination revealed a bright red growth attached to her anterior maxillary gingiva measuring about 1*1cm. Her oral hygiene was very poor. Dr.Sunil Richardson planned to do to a complete oral prophylaxis/scaling for her followed by an excisional biopsy. The excisional biopsy was done using electrocautery under local anesthesia to prevent chances of excessive bleeding. Biopsy report confirmed our provisional diagnosis of pyogenic granuloma. There have been no signs of recurrence on subsequent visits.