Epulis
An epulis (Greek: epūlis "on the gums", namely growing; plural epulides ) is a hemispherical or mushroom-shaped structure that usually sits on the gum line . Focal fibrous hyperplasia is synonymous .
It is a matter of granulation tissue formation with different cell structures. It arises as a reaction of the tissue to a chronic inflammation , which usually originated in a gingival pocket. An epulis can also arise from a long-term mechanical stimulus (from the edges of a filling, crown or prosthesis). In most cases, the removal of the tissue must be combined with the extraction of the tooth. Furthermore, the epulis behaves clinically like a tumor and can recede spontaneously, but also tends to recur .
An epulis on the gum is a classic example of what is known as a tumor-like lesion or a pseudotumor . This granulomatous pseudotumor shows histologically a large number of giant cells of the osteoclast type and is therefore also called giant cell pulis or epulis gigantocellularis . If the localization is not on the gums and has the same macroscopy and histology, it is called submucosal fibroma or irritable fibroma .
species
A distinction is made between the following types of epulis:
Epulis fibromatosa
“Superficially preserved squamous epithelium, occasional erosions / ulcerations on the tip; inside the knot there are broad, collagen-rich strands of fibers that form an even network with only a few inflammatory cells and small blood vessels in between. Primary or maturation stage of an epulis granulomatosa . "
Epulis granulomatosa
“Superficially preserved, widened or eroded / ulcerated squamous epithelium; underneath it a broad zone of loose connective tissue with abundant small newly formed blood vessels and many lymphocytes, plasma cells and macrophages; in the edge zone and in the basal sections there is usually a clear increase in fibers. Synonyms are epulis fissuratum , inflammatory fibrous hyperplasia . "
Epulis gigantocellularis
“Superficially multilayered squamous epithelium; towards the depth in small strands or fish-like arranged fibroblasts and differently dense network of newly formed fibers; in between abundant blood vessels and adjacent bizarrely shaped giant cells; Hemosiderin deposits; at the base erosion of the bone tissue. "
Epulis gravidarum
During pregnancy, a so-called pregnancy epulis can occur, which usually disappears after the child is born. It arises under the influence of sex hormones with a predisposing factor of a lack of oral hygiene. Under certain circumstances it can cause severe bleeding and then represents a danger to the pregnant woman and the unborn child. “Pregnancy sepulis is a hyperplasia consisting of granulation tissue with a pronounced vascularity. The proliferation tendency is favored by the changed hormonal situation ”.
See also
Page references
- ↑ definition-of.net ( page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.
- ^ University of Heidelberg, Institute for Pathology, Epulis ( Memento of the original from December 15, 2013 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ medeco: Tumors
swell
- Grundmann: General pathology and fundamentals of special pathology . Munich, 11th edition, Elsevier 2008, ISBN 978-3-437-41541-8
- Duden: Epulis
