Epulis – the opukholepodobny formation of productive character arising owing to influence of the local irritating factors. At an epulisa on a gum painless protrusion of a myagkoelastichesky or dense consistence is formed. Mucous over protrusion pale, red or cyanotic. Diagnostics of an epulis comes down to collecting complaints, clinical examination, a X-ray analysis and a histologic research of the material received during surgery. Treatment of an epulis includes elimination of the injuring factors, dynamic observation. At a gigantokletochny peripheral tumor excision of an epulis within healthy fabrics is shown.
Epulis – the myagkotkany good-quality formation of an oral cavity proceeding from periodontium fabrics. It is more often localized in the field of cutters, canines and small molars of the top jaw, less often the new growth is revealed on the lower jaw from the shchechny party of an alveolar shoot. Fibromatous equally often occurs at men and at women. The Angiomatozny form is diagnosed mainly for children. The main group of patients with a gigantokletochny peripheral epulis is made by women up to 30 years. In children's stomatology opukholepodobny education most often is found in the period of a replaceable bite. At children at the same time the retention of second teeth, divergence of roots is observed. A source of an epulis is the periodontium therefore on a toothless jaw the tumor develops extremely seldom. Isolated cases of emergence of an epulis at newborns are recorded.
Reasons and classification of an epulis
Epulis results from influence of the local irritating factors. Traumatizing desnevy edge the destroyed walls of teeth, not polished basis of an artificial limb, the metal klammer acting as elements or ridge edges of orthodontic designs leads to development of chronic inflammatory process of productive character. The contributing factors promoting emergence of an opukholepodobny new growth are occlusion pathologies, narrowing of tooth alignments, density of teeth, and also violations of a hormonal background.
On a histologic structure in stomatology distinguish 3 forms of an epulis:
- Fibromatous. It is characterized by slow growth. The new growth is painless, dense, does not bleed. The basis of a tumor is made by rough connecting fabric.
- Angiomatozny. Unlike a fibrous form, angiomatozny bleeds at insignificant traumatizing. During the palpatorny research a tumor painless, a soft consistence. It is characterized by a large number of blood vessels.
- Gigantokletochny. Is a peripheral form of a gigantokletochny tumor. At a palpation the new growth painless, a myagkoelastichesky consistence with a hilly surface, is covered by stagnant cyanotic-red mucous.
Symptoms of an epulis
At a fibromatous epulis on a gum there is a painless growth. At survey the new growth of roundish, is more rare than irregular shape on a wide leg. Surface of a fibromatous epulis smooth. At a palpatorny research the tumor of a dense consistence, from above is covered by whitish mucous. Angiomatozny – a new growth of red color, a soft and elastic consistence, with a melkobugristy structure, developing in a prisheechny zone of teeth. Bleeds even at insignificant damage. Quite often on a surface of an angiomatozny epulis reveal prints of teeth antagonists.
Gigantokletochny is localized on an alveolar shoot of a jaw, grows slowly. At achievement of the big sizes patients can have complaints to deterioration in chewing, swallowing violation. The teeth which are in a zone of growth of a new growth are displaced, become mobile. At survey the gigantokletochny peripheral tumor of a soft or dense consistence, with a hilly surface, from above is covered cyanotic mucous (sometimes with signs of ulcerations). Opening of a mouth at patients free, is carried out in full. Regionarny lymph nodes are not palpated. The general state is not broken.
Diagnostics of an epulis
Diagnosis is based on the basis of the collected complaints given the anamnesis, results of clinical and histologic researches. During fizikalny inspection the dentist reveals on a gum growth of rounded or irregular shape on a wide leg. Depending on a histologic structure the surface of an epulis can be a smooth or folded, soft or plotnoelastichesky consistence, a light pink, red or cyanotic shade. Grows slowly. At a gigantokletochny form the tumor reaches the big sizes, displacing the teeth adjoining and being in a zone of growth of a new growth. As a result of it intact teeth become mobile. At survey of tooth alignments the epulisa – the destroyed tooth, insolvent restoration, a keen edge of a crown in most cases is possible to establish the reason.
On the roentgenogram of tooth in process of germination of a tumor in a periodontium define the centers of depression of a bone tissue with indistinct contours without signs of periostalny reaction. At a histologic research of a gigantokletochny epulis multinuclear cages, macrophages, grains of a gemosiderin find. Fibromatous it is presented by the expanded coarse-fibered fabric with insignificant sites of calcification. At an angiomatozny form the basis of an epulis is made by an extensive network of blood vessels. Differentiate with papilloma, oral cavity fibroma, a hypertrophic gingivit, a desnevy polyp. Examination is conducted by the stomatologist-surgeon.
Treatment of an epulis
Priority at identification of an epulis is elimination of the local irritating factors, namely – removal of tooth deposits, treatment of caries and its complications, rational prosthetics, isolation of speakers of elements of orthodontic designs. At angiomatozny and fibromatous forms dynamic observation as after sanitation of an oral cavity and elimination of a causal factor reduction of an epulis in sizes is possible up to its total disappearance is shown.
At a gigantokletochny peripheral tumor carry out excision of a new growth within healthy fabrics together with a periosteum. Tactics concerning the teeth which are in a zone of growth of an epulis depends on the yielded fizikalny survey and results of a X-ray analysis. At considerable destruction of a bone of interalveolar partitions, high degree of mobility teeth are subject to removal. If the causal factor which caused emergence of a new growth is not in due time revealed and eliminated, the probability of a recurrence is very high even after surgical excision of a tumor. At complex diagnostics and the qualified treatment the forecast favorable.