👉 Epulis means “upon the gum”. It refers to a solid swelling situated on the gingiva.
👉 It arises from the alveolar margin of the jaw.
👉 The swelling is usually painless.
Classification of Epulis ➡️ Based on it’s consistency:
⚫ Soft Epulis – Granulomatous
⚫ Firm Epulis – Fibrous, Giant cell
⚫ Hard Epulis – Carcinomatous
⚫ Malignant Epulis – Carcinomatous
⚫ Dangerous Epulis – Fibrosarcomatous
🔼 Consistency: Soft to firm fleshy mass
🔼 Clinical Presentation: Manifests as a mass of granulation tissue around the teeth on the gums. It bleeds on touch.
🔼 Example: Pregnancy Epulis (gingivitis gravidarum)
Fibrous Epulis: (⭐ most common)
🔼 Consistency: Firm polypoidal mass
🔼 Clinical Presentation: Slow growing, non tender, a simple fibroma arising from the periodontal membrane, presents on the gum. May undergo sarcomatous change.
Giant Cell Epulis: (⭐ AKA Myeloid Epulis)
🔼 Consistency: Soft to firm gums with indurated underlying mass due to expansion of bone.
🔼 Clinical Presentation: It is an osteoclastoma arising in the jaw. Presents as hyperaemic vascular, oedematous, may ulcerate and result in haemorrhage. X ray shows pseudo trabeculation.
🔼 Treatment: Small tumours are treated by currettage; Large tumours are treated by radical excision.
🔼 Consistency: Hard or malignant in consistency.
🔼 Clinical Presentation: This is an epithelioma arising from mucous membrane of the alveolar margin. Presents as a non healing, painless ulcer slowly infiltrating the bone. Hard regional lymph nodes are due to metastasis.
🔼 Treatment: Wide excision which includes removal of segment of the bone.
SOURCE: Manipal Manual of Surgery (3rd edition)