Introduction
Epulis fissuratum, a mucosal proliferation is brought on by continuous low-grade trauma which is caused by a denture flange. Epulis fissuratum can be comparable to the skin's acanthoma fissuratum. While epulis fissuratum is often regarded as a benign condition, it is crucial to remember that any oral lesion or oral and mucosal growth should be evaluated, examined, and identified by a skilled dentist or oral surgeon. It is advised to obtain expert medical consultation if a person thinks they may have epulis fissuratum or any other oral health issue to ensure correct diagnosis and treatment. The standard course of treatment is completely removing and eradicating the growth, along with addressing the underlying issue, such as correcting the ill-fitting and replacing loose dentures.
What Is the Pathophysiology of Epulis Fissuratum?
Epulis fissuratum arises in association with denture flanges (part of the denture that extends from the teeth up to the peripheral borders). Consequently, epulis fissuratum is usually observed in the maxillary or mandibular vestibule (it is a space between the upper and lower teeth, lips gingiva, and cheeks) of the oral cavity. The cause of epulis fissuratum is supposed to be chronic low-grade irritation from an ill-fitting denture. Frequently, this is the consequence of resorption of the bony portion of the maxillary and mandibular ridge, also known as the alveolar ridge. The denture moves further into the vestibular mucosa, creating an inflammatory fibrous hyperplasia that proliferates over the dental and mucosal flanges.
What Are the Causes of Epulis Fissuratum?
Chronic friction or irritation brought on by wearing dentures or other dental equipment that does not fit properly is the main cause of epulis fissuratum. Dentures that do not fit properly might rub against the soft oral tissues, causing irritation and a broadening of fibrous tissue. Typical reasons include:
- Ill-fitting Dentures - Epulis fissuratum can form as a result of friction caused by dentures that are not correctly fitted, are too loose, or have rough surfaces against the underlying tissues.
- Poor Oral Hygiene - Poor dental hygiene habits, particularly during wearing dentures, can cause tissue inflammation, pain, tissue irritation, and tingling, which can make the situation worse and can lead to epulis fissuratum.
What Are the Symptoms of Epulis Fissuratum?
Epulis fissuratum is commonly seen in the region where the denture flange comes into touch with the oral mucosa and cavity, and it is the consequence of persistent irritation or damage brought on by poorly fitting dentures. The symptoms appear very late, and the people usually show no symptoms. The following list of epulis fissuratum symptoms is typical:
- Abrupt Growth in the Soft Tissues of the Oral Cavity- Epulis fissuratum manifests as a soft, fleshy, pink to red tissue that grows along the edge of a denture or other mouth device. It frequently looks lobulated or wrinkled.
- Discomfort or Pain in the Oral Cavity- Because of its position and contact with the oral tissues in the area, the growth due to epulis fissuratum may result in pain, discomfort, and or a sense of pressure on the area where the growth occurs.
- Bleeding From the Oral Cavity- If the tissue development is irritated or harmed when being used to clean the denture or while eating, it may be more prone to bleeding.
- Ulcers in the Oral Cavity- Occasionally, the epulis fissuratum may develop or cause an ulcer, which can result in exposed sores on the growth's surface. This could make the discomfort and suffering worse.
- The Patient Faces Difficulty While Swallowing and Chewing- Due to the growth, it may be more difficult to speak or chew with the denture in place.
- The Fitting of the Denture Changes and Causes Alteration- As the epulis fissuratum develops and alters the denture fitting of the mouth, the denture may become even more ill-fitting over time.
How Is Epulis Fissuratum Treated?
Epulis fissuratum can be treated by surgically removing the extra tissue or the growth and correcting the underlying problem related to the epulis fissuratum, which is frequently poorly fitting dentures. The summary of these medical processes is as follows:
- Denture Adjusting for a Proper Fit: The first step is to deal with the irritant's source that is creating problems for the patient. This frequently involves replacing or modifying the irritating uncomfortable denture. Smooth surfaces that do not rub against or irritate the oral tissues and the oral mucosa are characteristics of a well-fitting denture in the patient.
- Removing the Tissue Growth in the Oral Cavity: Surgical removal may be advised when there is significant excess tissue growth in the oral cavity that is uncomfortable and causes irritation to the patient. An oral surgeon often performs this treatment of tissue removal. After the tissue has been removed, appropriate healing and rehabilitation are crucial. To make sure the healing process is going well, patients should diligently follow the post-operative instructions as suggested by the dentist and practice excellent dental hygiene, along with attending the suggested follow-up consultations.
What Is the Prognosis of Epulis Fissuratum?
Epulis fissuratum has a better prognosis for the patients. It does not cause any serious complications in the patient and is particularly a safe lesion. The lesion often subsides and regresses if the underlying and the main cause of irritation of the dental tissue, which is typically poorly fitting dentures in this case, is taken care of and treated. This can be accomplished by improving the fit of the dentures or changing them to get rid of the source of ongoing current irritation which is causing epulis fissuratum. If the irritant is eliminated and the patient maintains excellent oral hygiene, the lesion should typically progressively shrink over many weeks to months.
However, the recovery process can be different for each person, but for an accurate and correct diagnosis and the best course of treatment, those with suspected cases of epulis fissuratum should have a detailed discussion with an oral healthcare expert. To confirm the diagnosis by the doctors and rule out any further potentially dangerous underlying condition, a biopsy may occasionally be done.
How Can the Occurrence of Lesions Be Prevented?
The occurrence of epulis fissuratum can be prevented by explaining to the patient the importance and value of routine dental care and the ongoing evolution of the changes that are noticed in the oral tissues. This implies that dentures require changes and adjustments with time and are not permanent. So, patients who wear dentures should make a point to visit the dentist on a timely basis or as scheduled.
Conclusion
Epulis fissuratum is a widespread oral disease brought on by persistent itchiness from improperly fitted dentures or dental equipment. This condition can be effectively and well prevented and managed by recognizing the signs, obtaining dental and medical treatment in a timely and proper manner, and practicing excellent and good dental hygiene habits. Consult a dental expert for an accurate diagnosis and advice if one has epulis fissuratum or is experiencing any other alarming oral health concerns.
