Dentistry, as well as other areas of medicine, is distinguished by the presence of many diseases. Quite often people in the oral cavity are bothering unpleasant tumors. This refers to epulis. If specifying, then epulis is a mushroom-like neoplasm on the gum. I am glad that it is mainly not delivering strong pain (if the tumor is not malignant) and only aesthetic discomfort causes. May meet all people, children are also no exception. It is interesting, but it was recorded that Epulis arises several times more often in women than men.
Tumor education is mainly appearing near indigenous teeth (premolars). The color of epulis is similar to a reddish tint of the gums. But sometimes education can acquire a bluish color.
The dimensions of the messenger epulis can be different. In a serious stage can reach pretty large sizes. The following range: 2 mm - 3 cm in diameter. The neoplasm becomes very noticeable when talking, smile or during the opening of the mouth.
With the appearance of epulis looks like the growth of the gum itself. If we consider a tumor like a mushroom form, then several features can be distinguished. On the outside, only his hat is visible. The leg of epulis is attached to the teeth. Only a dentist can see these features.
To the touch, the tumor can be solid, or maybe, on the contrary, be too soft.
If epulis was purchased due to injury with a prosthesis, a seal or edge of the tooth, a ulcer is often formed on its surface.
Views of epulisa
- Angiomatous epulis. They suffer these types of predominantly children 5-10 years old and adolescents until 18. There is Epulis mainly at the neck of the tooth. Visually, the tumor has a bright red color (due to the presence of a set blood vessels) And the rough surface. The base of the tumor is wide. When touching an angiomatous epulis is distinguished by its softness and can quickly start bleeding. This tumor grows pretty quickly. After removal, it is usually anew.
- Fibrous epulis. The consistency of fibrous epulis is quite dense with a wide base. In color, this type of tumor is similar to the color of the gums. There is no bleeding. Education grows slowly (the slowest of all kinds), but reaches large sizes. To do x-rayYou can see a round or oval seal. This species often occurs on the vestibular side of the gums.
- Giant meal epulis. The exact diagnosis is set only after the X-ray. The snapshot usually shows a clear outline in which the destruction occurred. bone tissue. This type of neoplasm grows very slowly. The color of epulis is basically a blue-bug. It can bleed, but not often. This epulis is most often sick patients 40-60 years old. In women, giant meal epulis occurs more often.
Malignant education
The above types are characteristic of a benign tumor. Malignant education is characterized by the following features:
- Fast growth.
- Pretty big sand edema.
- Severe pain and high sensitivity when touched.
- White foci.
- Destruction of root canals located near inflammation.
- Abundant bleeding.
- Ulcers.
- Cracks.
In the case of a fatal outcome may occur. But this is a rather rare phenomenon for this reason. The most important thing here is timely and in time to discover the problem. Light forms of the disease are treated faster and more productive.
The final diagnosis is made by a doctor after clinical studies and histological examination.
Causes of epulis on the gum
The tumor may appear in the oral cavity for various reasons:
- Strong and minor bruises.
- Incorrectly made and installed prostheses and their wearing without the necessary fit.
- Strong dental stone.
- Malocclusion.
- Destroyed tooth with sharp edges.
- Speaking and hanging seals.
Leakage of the disease
Children often occurs an angiomatous epulis. But other species may also arise. Girls have a tumor more often than that of boys. Usually the disease amazes small patients during the period of teething. Why is this happening? The teething is accompanied by a strong injury to the gums and mucous membranes. The tumor is growing greatly in the oral cavity and begins to disturb. Child parents need to seek as quickly as possible for help from a specialist. The faster the help will be provided, the easier the consequences will be.
Teenagers Epulis also may arise as a result of injury. Another reason is hormonal perestroika organism. Most often, the tumor occurs at the stage of puberty. It may also occur as a result of the reception of unsuitable drugs.
Interestingly, but children often have one form of epulisa goes into another. For example, in the occurrence of granulomatous epulis, this species over time goes into angiomatous, and then to fibrous. Such a transition is observed in 14% of the occurrence of the disease.
Because of the hormonal failure or restructuring of the body, epulis occurs in pregnant women. If they add injury, then the tumor growth passes rather quickly.
Removal epulisa
Epulis gums remove surgically. For this, the incision is made equal to about 2-3 mm and the removal of education. After removal, the edges are combined. The wreck is covered on top of gauze, which is wetted in the iodoform mixture. Another option: on the wound put the mucosa flap.
Rarely adjacent teeth are resorted to removal. Basically only with their excessive mobility and with strong indent roots. If the bone is strongly amazed or a recurrence of the disease occurred, then a partial resection is performed. Under the influence of the teeth and the alveolar part of the gums. With such treatment, a positive outcome often happens. If you do the operation incorrectly, it may be recurrence.
The operation is carried out under anesthesia. A qualitatively performed epulis removal procedure ensures no consequences and rapid wound healing. Therefore, it is necessary to take carefully to choosing a good specialist.
Modern dentistry often use a laser to carry out such interventions. In this case, infiltration anesthesia usually make. The use of the laser is beneficial to the fact that they are carried out simultaneous elimination (cavity) and disinfection of the region. As a result, the period of rehabilitation is reduced and complications almost do not arise.
To possible postoperative consequences Believe:
- Bleeding.
- Suppuration.
In all cases, urgent help of a specialist is necessary. Treatment of such consequences is often carried out with the help of antibiotics and the use of rinse compositions.
Folk remedies
Fully cure epulis on the gum folk remedies It is impossible. But it is possible to make a rehabilitation period easier and short. Healing will be much faster. The essence of treatment with folk remedies is to carry out rumors of herbs. In practice, several recipes are used:
- First recipe. Calendula is used as the main ingredient. For cooking, you need two tablespoons of plants to pour a glass hot water. Let stand until the cooling. During this time, the solution will type the desired concentration. For effective treatment You need to rinse your mouth 3-4 times before the onset of explicit relief.
- Second recipe. The ingredients are sage, eucalyptus and chamomile. Dry herbs are mixed in an equal ratio. Two table horns of the resulting mixture and a glass of boiling water takes for cooking. The time of insteading and the number of rinsing is the same as in the past recipe.
- Third recipe. Baking soda Helps prevent the appearance of inflammation and pus. Therapeutic mixture is prepared as follows: in a glass clean water A teaspoon of soda is added. Rinse need 3-4 times.
- Fourth recipe. The composition is prepared with the use of food salt. To do this, the spoon is dissolved in a glass of boiling water. The resulting solution relieves swelling well and prevents the reproduction of bacteria. Just use it after complete cooling.
Preventive actions
Prevention consists in regular processing of the oral cavity. It should be understood that due to hormonal disordersThe disease can still occur.
It is necessary to resort to the rehabilitation of the oral cavity in the walls of the clinic. In addition to processing, dentists remove the dental and hold professional cleaning. If doctors need to make bite correction, which also leads to the formation of epulis. As a result, the risk of tumors and other dental diseases is reduced by a significant number of times.
In addition to the above, it is very important to avoid the injuries of the gums and to identify dental diseases in a timely manner.
Possible complications
Tumor removal is rarely accompanied by complications. But if these are found, then mainly it is:
- New tumor growth in the old place (relapse).
- Abundant or weak bleeding.
- Putting the fabrics (usually occurs due to entering various bacteria).
- Powder after surgery.
In the case of complications, follow these recommendations:
- Strictly follow the rehabilitation of the oral cavity.
- Perform all the recommendations of the doctor.
- Take preparations assigned by a specialist.
Reviews
Ksenia, 36 years old, Moscow
I myself encountered epulis on the gum. Nasty thing. Finding the tumor seriously prevented me. I did not even immediately understand and did not realize her appearance. It was still determined that this is an abnormal phenomenon, the tumor reached quite large sizes. On the primary reception in the clinic, I was stated that the neighboring teeth were not injured and they would not delete them. Then I remember, I sighed. Operation itself did not seem very terrible. It was performed by a laser under local anesthesia. In the queue with me, a pregnant woman was sitting on the bench. I hardly understand what it is for the need to remove the tumor in its position. But maybe she had complex situations, I am ashamed. After surgery, I processed purph cavity conventional soda solution. The wound was quickly dragging over and stopped disturbing. All this happened more than 4.5 months ago. To my joy, at today's moment, I did not have a relapse.
Karina, 33 years old, Moscow
Epulis suffered from my six-year-old son (he has an wrong bite). We did not immediately find a tumor. Son did not complain. More precisely, the disease revealed a dentist at the next inspection. We regularly go to the doctor before starting school year. I was unpleasant surprised. I read a lot about Epulis and realized that it was a bad thing. It was especially frightened by her possible malignancy. As this thing appeared at a small child, it is not clear. The son was terribly felt before surgery (crying, was afraid, shouted) and during the procedure. After the removal made, I brought to the Son that if you do not rinse with special means, the tumor may appear again. Therefore, son strictly observed all the recommendations. He even enjoyed holding procedures. And he began to remind me of rinsing. As a result, we quickly went on amendment. Now I carefully follow his mouth. We continue to rinse folk remedies for prevention.
RCRZ (Republican Center for Health Development MD RK)
Version: Clinical Protocols MOR RK - 2015
Other refined changes in gums and toothless Alveolar Territory (K06.8)
Maxillofacial Surgery
general information
Short description
Recommended
Expert Council
RGP on PFV "Republican Center
Health Development »
Ministry of Health
and social Development
Republic of Kazakhstan
from September 15, 2015
Protocol No. 9.
Epulis.- Tumor-like damage to the alveolar process of jaws.
Protocol name:Epulis.
Protocol code:
Code (s) μb-10:
K06.8 Other refined changes in gums and toothless Alveolar Territory.
Reductions used in the protocol:
AST - aspartatenososferase;
Alt - alaninotransferase;
CT - cT scan;
LFK - physiotherapy;
Oak - general blood analysis;
OAM - general urine analysis;
UHF - ultra-high frequency;
Ultrasound - ultrasound procedure;
UFO - ultraviolet irradiation;
ECG - electrocardiogram;
Ehoche - Echocardiogram.
Protocol development date:2015 year.
Protocol users: Doctors maxillofacial surgeons, oncologists.
Assessment on the degree of evidence of the recommendations given.
The scale of the level of evidence:
| BUT | High-quality meta-analyzing, systematic Overview of RKK or large rock with a very low probability (++) systematic error Results. |
| IN | High-quality (++) systematic overview of cohort or studies Case control or high-quality (++) cohort or studies Case control with a very low risk of systematic error or RCC with not high (+) systematic error. |
| FROM | Cohort or study case-monitoring or controlled study without randomization with a low risk of systematic error (+). |
| D. | A description of a series of cases or an uncontrolled study, or the opinion of experts. |
| GPP. | Best pharmaceutical practice |
Classification
Clinical classification
:
· fibrous epulis;
· Angiomatous epulis;
· Peripheral giant meal epulis.
Diagnostics
List of diagnostic measures:
Main (mandatory) diagnostic surveys on the outpatient level:
· OAK;
· Radiography of the jaws.
The minimum list of the survey, which must be carried out in the direction of the planned hospitalization: according to the internal regulation of the hospital, taking into account the current order of the authorized body in the field of health.
Main (mandatory) diagnostic surveys conducted at the stationary level:
· OAK;
· OAM;
· Determination of blood type on ABO standard serum;
· Determination of blood reserves;
· Biochemical analysis blood (protein, bilirubin, alt, aste, glucose, thymol sample, urea, creatinine, residual nitrogen);
· histological examination (UD-D).
· Coagulogram (PH, prothrombin time, me, fibrinogen, ARTV, thrombin time, ethanol test, thrombotest).
Additional diagnostic surveys conducted at the stationary level:
· CT skull;
· CT jaws;
· Determination of electrolytes: potassium, sodium, chlorides;
Diagnostic measures carried out at the emergency stage:not.
Diagnostic criteria for diagnosis:
Complaints and history:
Complaints:
· For the presence of education in the oral cavity;
· Violation of food intake function, speech (for large sizes);
· Bleeding during injury.
Anamnesis:
· Slow painless growth for several months.
Physical examination:
Fibrous form:
· Education rounded or incorrect form, located with the vestibular side of the gums on a wide, less often a narrow base (leg) and inserts to the teeth, can spread through an interdental gap to orally;
· Covered pale pink mucous membrane, has a smooth or barride surface, a dense elastic consistency, painless, not bleeding.
Angeomatous form:
· Located in the neck of the tooth;
· Smallobugrous, less often a smooth surface, bright red color with a cyanotic tint, relatively soft consistency.
· Blood even with easy injury.
Peripheral giant shape:
· Painless formation of a rounded or oval form;
· Cheep surface, soft or dense elastic consistency, blue-bugs.
· Located on the alveolar part of the jaw, bleeding.
· Seen presants from antagon teeth.
· The teeth to which epulis arrive, are shifted, and loosened.
Laboratory research:
· Histological examination - the growth of granulation tissue with the predominance of fibrous tissue; (with fibrous epulis)
the growth of granulation tissue with the predominance of angomatosis; - (with angiomatous epulis).
Tools:
Radiography of jaws:
· Fibrous form: resorption of the edge of the alveolar process;
· Angiomatous: no changes;
· Peripheral giant shape: degradation of the cortical plate of the alveolar process of jaws.
Indications for the consultation of narrow specialists:
· An oncologist - for the formulation of the final diagnosis, and the preparation of the treatment plan.
Differential diagnosis
Differential diagnosis (UD-B):
| № | Nosology | Major Clinical Differential Diagnostic Criteria |
| 1. | Hypertrophic gingivitis | Accompanied by spontaneous bleeding, sometimes insignificant pain. Gantry nipples and the gum edge are not only hypertrophied, but also hyperticated. |
| 2. | G1 polyp. | it has a more dense consistency, a shiny color, a shorter and wide leg, has less mobility. |
| 3. | Fibroma | Localled on the mucous membrane of lips, cheeks, gums, soft Naba, less rare language, located on a wide base or on a thin leg, has a rounded, less often a noded shape, covered with a mucous membrane of pale pink. |
Treatment abroad
Treat treatment in Korea, Israel, Germany, USA
Treatment abroad
Get advice on medical examination
Treatment
C.
ate treatment:
· Operational removal of the neoplasm;
· Restoration of the defect of bone tissue;
· Recovery of functions.
Tactics of treatment .
1. Clinical X-ray examination;
2. Operational treatment;
3. Medical treatment;
4. Preventive actions;
Not medicia treatment:
· Common mode.
· Diet - table №15.
Medical treatment:
| № | Preparation, form of release | Dosing | Duration and purpose of application |
| Antibioticoprophylaxis | |||
| 1 |
Cefasoline Powder for preparing a solution for injection of 500 mg and 1000 mg |
1 g in / in (children at the rate of 50 mg / kg once) | 1 time 30-60 minutes before the cut skin Pokrov; In surgical operations, 2 hours and more - additional 0.5-1 g during the operation and 0.5-1 g every 6-8 hours during the day after the operation in order to prevent inflammatory reactions |
| 2 |
Cefuroxime +. Metronidazole. Cefuroxime powder for the preparation of a solution for injections of 750 mg and 1500 mg Metronidazole. Solution for infusion 0.5% - 100 ml |
Cefuroxime1.5-2.5 g, in / in (children at the rate of 30 mg / kg once) + Metronidazole.(Children at the rate of 20-30 mg / kg once) 500 mg V / V |
for 1 hour Before the cut. If the operation lasts more than 3 hours repeatedly after 6 and 12 hours Similar doses, in order to prevent inflammatory reactions |
| When allergic to β-lactam antibiotics | |||
| 3 |
Vancomycin Powder for making a solution for infusion 500mg and 1000 mg |
1 g / in (children at the rate of 10-15 mg / kg once) | 1 time 2 hours before the cut of the skin. No more than 10 mg / min is introduced; The duration of infusion must be at least 60 minutes, in order to prevent inflammatory reactions |
| Opioid analgesics | |||
| 4 |
Tramadol. solution for injection 100mg / 2ml 2 ml, or 50 mg orally |
Adults and children under the age of 12 are administered intravenously (slow drip), intramuscularly 50-100 mg (1-2 ml of solution). In the absence of a satisfactory effect after 30-60 minutes, an additional administration of 50 mg (1 ml) of the preparation is possible. The multiplicity of administration is 1-4 times a day depending on severity owl syndrome and the effectiveness of therapy. Maximum daily dose - 600 mg. Contraindicated children under 12 years old. |
|
| 5 | Trimeperidinsolution for injection 1% -1 ml |
Introduced in / in, in / m, p / k 1 ml of 1% solution, if necessary, can be repeated after 12-24 h. Dosage for children older than 2 years Makes 0.1 - 0.5 mg / kg body weight, if necessary, repeated administration of the drug is possible. |
in order to anestheticing in the postoperative period, 1-3 days |
| Nonteroidal antiberial means | |||
| 6 |
Ketoprofen. Injection solution 100 mg / 2m - 2 ml, or 150mg prolonged or 100mg orally. |
daily dose at V / B is 200-300 mg (should not exceed 300 mg), then oral application Prolonged 150mg 1 time per day or 100 mg 2 times a day |
The duration of treatment at the / in should not exceed 48 hours. Duration general It should not exceed 5-7 days, with an anti-inflammatory, antipyretic and painful goal. |
| 7 |
Ibuprofen suspension for reception inside 100 mg / 5 ml100ml; or 200 mg; Orally, granules for the preparation of a solution for reception inside 600 mg |
For adults and children from 12 years old, ibuprofen is prescribed 200 mg 3-4 times a day. To achieve a rapid therapeutic effect in adult dose, it can be increased to 400 mg 3 times a day. Suspension - one-time dose is 5-10 mg / kg body weight of a child 3-4 times a day. The maximum daily dose should not exceed 30 mg per kg of the body weight of the child per day. |
No more than 3 days as an antipyretic agent No more than 5 days as an anesthetics With anti-inflammatory, antipyretic and painful goal. |
| 8 |
Paracetamol200 mg, 500mg; suspension for reception inward 120 mg / 5 ml; or rectally 125 mg, 250 mg, 0.1 g |
Adults and children over 12 years old with a body weight over 40 kg:one-time dose - 500 mg - 1.0 g of 500 mg- 1.0 to 4 times a day. The maximum one-time dose is 1.0 g. The interval between receptions is at least 4 hours. Maximum daily dose - 4.0 g. Children from 6 to 12 years old: one-time dose - 250 mg - 500 mg, 250 mg - 500 mg to 3-4 times a day. The interval between receptions is at least 4 hours. Maximum daily dose - 1.5 g - 2.0 g. |
Duration of treatment when applied as analgesic and as an antipyretic agent for no more than 3 days. |
| Hemostatic means | |||
| 9 |
Ethailate Solution for injection 12.5% \u200b\u200b- 2 ml |
4-6 ml of 12.5% \u200b\u200bsolution per day. Children are introduced once intravenously or intramuscularly at 0.5-2 ml, taking into account body weight (10-15 mg / kg). |
With the danger of postoperative bleeding introduced with a preventive purpose |
Other types of treatment:
Other types of treatment rendered on the outpatient level:
· Elimination of "causal" factors (stalking of sharp edges of teeth, correction of dentures).
Other types of treatment rendered at the stationary level:not.
Other types of treatment rendered at the stage of ambulance:not.
Surgical intervention:
Surgical intervention rendered on outpatient conditions:not.
Surgical intervention provided in stationary conditions:
· Exciration of the affected jaw dentition
Indications: Deleting education;
· Alveoloplasty;
Indications:
· Replacement of the defect after resection of the alveolar process in auto sound.
Further maintenance:
· Orthopedic, orthodontic treatment.
Treatment Efficiency Indicators:
· Full removal of the neoplasm;
· Lack of recurrence
· Restoration of chewing function
Preparations ( active substances) applied in the treatment
Hospitalization
Indications for hospitalization.
Emergency hospitalization testimony: not.
Indications for planned hospitalization:
· Bleeding of education;
· Violation of food intake, speech;
X-ray: destruction cortical plate alveolar jaw process
Prevention
Preventive actions:
· Exclusion of loads;
· Prevention of purulent inflammatory complications.
Information
Sources and literature
- Protocols of the meetings of the Expert Council RCRs MZSR RK, 2015
- List of references: 1. Surgical dentistry: textbook / ed. T.G. Robustova. - M.: Medicine, 2002. - 59 P.L. 2. Sabo Sabo Surgery of the oral cavity and maxillofacial area. - Kiev: Book plus. - 2005. - 302 p. 4. Karapetyan I.S., Gubaidullina E.Ya., Cegelnik L.N. Tumors and tumor-like lesions of the oral cavity of the mouth of jaws, faces and neck M.: Medical information agency, 2004. - 232 p. (2nd ed., Pererab. And add.) ISBN 5-89481-207-0 5. Kulakov A.A. Surgical dentistry and maxillofacial surgery. National Guide / Ed. A.A. Kulakova, T.G. Robustova, A.I. Narobeeva. - M.: Goeotar Media, 2010. - 928 p. 6. Operative Oral and Maxillofacial Surgery John Langdon, Mohan Patel, Peter Brennan, Robert A. Ord. Hodder Arnold. 2011 7. Essentials of Oral and Maxillofacial Surgery Lars Andersson, Karl-Erik Kahnberg, M. Anthony Pogrel. Wiley-Blackwell (An Imprint of John Wiley & Sons Ltd) 2014. 8. Oral and Maxillofacial Diseases. Crispian Scully, Stephen Flint, Stephen R. Porter, Khursheed Moos, Jose V. Bagan. Informa Healthcare. 2010 9. Mukovozov I.N. Differential diagnosis of surgical diseases of the maxillofacial region. Medpress 2001. - 224 c. 10. Differential Diagnosis of the Giant Cell Epulis: The Malignant Melanoma of The Oral Mucosa: A. Koch, C Boldt, G. Hilge, U. SchüttrumPf. Mund Kiefer Gesichtschir 1998; 2: 160-162). British Journal of Oral and Maxillofacial Surgery, Vol. 36, ISSUE 4, P315 Published in Issue: August 1998
Information
Protocol Developer List:
1. Batyrov Tuleubai Uralbayevich - the main freelance ministry surgeon MZSR RK, doctor of the maxillofacial surgeon of the Higher Category, Professor, Candidate of Medical Sciences, Head of the Department of Dentistry and Maxillofacial Surgery, JSC "Medical University Astana"
2. Zhanalina Bakhyt Sekersbekovna - the main freelance jewish facial surgeon of Aktobe region, doctor of the highest category, professor, head of the department of surgical dentistry and dentistry children's age. RGCP on the PVV "West Kazakhstan Medical University named after M. Sepanova";
3. Sagyndyk Hasan Lukotovich - doctor of the maxillofacial surgeon of the highest category, Candidate of Medical Sciences, Professor of the Department of Dentistry and Maxillofacial Surgery JSC Medical University of Astana;
4. Ihambaeva Ainur Nygymanovna - Clinical Pharmacologist, Assistant Department of General and Clinical Pharmacology JSC Medical University Astana
Indication for the absence of conflict of interest:not.
Reviewer:Mirzakulova Ulmeken Rakhimovna - doctor of the maxillofacial surgeon of the Higher Category, Doctor of Medical Sciences, Professor, Head of the Department of Surgical Dentistry of RGP at PVV "Kazakh National Medical University named after S. D. Asfendiyarov".
Protocol revision conditions: Revision of the Protocol in 3 years and / or when new diagnostic / treatment methods appear with a higher level of evidence.
Attached files
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Epulis is a generalized name of tumor formations of different origin on the gum May meet in young and mature age, but women due to hormonal oscillations are diagnosed 3-4 times more often than in men. In addition to hormonal failures, the main causes of the development of these formations are chronic gum injuries. They may be provoked mechanical damage various character: burns, sharp edges of teeth, hanging seals, launched tooth stone, bite anomalies and uncomfortable dentures. In this regard, it is very important to promptly visit the dentist to eliminate provoking factors.
In most cases, epulisses do not deliver special troubles, with the exception of small discomfort and inestretical external view. However, it all depends on their size and clinical manifestations. Epulisa with a diameter of up to 2-3 cm, which have no tendency to rapid growth, are benign. In this form, there are no complaints about soreness, the edema of the gums or the loosening of the teeth. For malignant formations, the presence of point foci is characterized. white color, very rapid growing, painfulness, bleeding and destruction of teeth roots in the localization of the tumor.
Main classification of epulisov
Three main forms distinguish: angiomatous, fibrous and giant. The first two types affect teeth, and the third can develop in the places of their absence. In addition, when x-ray study Angiomatous and fibrous form are not detected by changes in the bone, and with gianthell, they can be expressed.
Angiomatous It is usually found at a young age and is manifested by the growing of soft tissues of the gums, purchasing bright red color. Education contains a large number of Blood vessels and localizes mainly in the neck of the top or lower jaw teeth. The surface is littering, and the consistency is solid. Such tumors are bleeding, grow rapidly and after removal tend to relapses.
Fibrous epulis More often develops among middle-aged people and is a rounded formation of dense consistency with bone splashes. The surface can be both smooth and bug, and its main localization is the vestibular side of the premolars and the first molars. In color, fibrous epulis is identical to the natural tint of the gums. Unlike the previous species, this education is not bleed and grow very slowly.
Diagnosis and treatment of epulisses
The methods of diagnosis of such formations include a visual inspection by a dentist, instrumental study and radiography to identify the involvement of bone tissue into the process. To form the final diagnosis and determination of the form of epulis (benign or poorly quality), the patient is directed to a common and detailed blood test. With adverse analyzes, especially with elevated leukocytes, a histological study of the material taken is subsequently carried out. In general, treatment is very successful, since recurrences occur only in 10-14% of cases.
The main method is the removal of the surgical path of not only the education itself, but also of all damaged tissues. Removal must occur in a timely manner until epulis touched the large sections. Most often, the operation is carried out under general anesthesia Using a laser that allows you to catch up and simultaneously disinfect the processed zones. For faster healing in the rehabilitation period, rinsing and additional preparations for receiving can be assigned. There is also drug treatment with the use of drugs that stop tumor growth and contributing to the rapid regeneration of tissues.
Epulis: Classification, pathological anatomy, clinic, diagnosis, differential diagnosis, treatment.
Epulis - the concept of a certain degree of collective, uniting various tumors and tumor formations, developing on an alveolar jaw processing, in its nature.
Clinic
Histologically distinguish between epulisov's histologically distinguish:
1) Granulomatous.
The granulation tissue in various stages of the fibrous transformation is noticeably dominated, up to the formation of coarse-fiber granulation tissue.
2) angioatous.
In addition to the elements inherent in the first group (the presence of fibrous and granulation tissue), contains a large number of blood vessels.
3) gianthell.
They are connecting formations with a large number of giant multi-core cells. However, these cells do not possess atypical growth and, overcoming a certain cycle of development, turn into a complete mature benign (fibrous tissue).
Pathological anatomy
The outer surface of the epulis is covered with epithelium, often a rather thick layer. The tumor consists of elements of connective tissue and blood vessels. The overall histological characteristics lies in the absence of atyphen cells and the gradual transition of the tumor into fibrous mature fabric.
Clinic
Fibrous epulisses have a density consistency, round or oval shape. The surface of their smooth or steepobugrous. Usually they are located on a wide base, but may also have a pronounced leg. Mucous membranecovering epulis, pale pink color. The growth of their very slow, significant sizes are rarely achieved.
Angiomatous epulis is localized mainly in the side departments of jaws. The growth of soft tissues of the gums has a bright red color with a cyanotic tinge, a soft-elastic consistency. The surface of epulisa in most cases is fine-minded, less frequently smooth. Character. A feature of this type of tumor is the easiest bleeding (even with the slightest touch), having often pulsating character. Epuls are growing relatively quickly and prone to relapses, especially during pregnancy.
Gigantaeer epulis has a rounded, less often an ellipse form, a smooth surface, a soft or elastic-elastic consistency, a dark red color, more often a consistency, a dark red color, more often with a pronounced brown tint. Possessing progressive growth can reach large sizes. They are painless, moderately bleeding during injury. Sometimes on the surface of epulis, you can see the prints of antagonist teeth.
Diagnostics
The diagnosis is made on the basis of the data of the clinic and the results of histological research.
Differential diagnosis
It is necessary to differentiate with hypertrophic gingivitis, which is the growth of the gum papilla. The source tissue of epulis in one in some cases is the pericient of the tooth or the perception of the alveoli, in others - the endoost and bone marrow of the spongy wall of the alveoli wall.
Treatment
The treatment consists in excision of epulis within the limits of healthy tissues with the destruction of the growth zone. Often you have to remove intact teeth in the localization area of \u200b\u200bthe tumor.
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Epulis: Classification, Pathological Anatomy, Clinic, Diagnostics, Differential Diagnostics, Treatment
Epulis - the concept of a certain degree of collective, uniting various tumors and tumor formations, developing on an alveolar jaw processing, in its nature.
Clinic
Histologically distinguish between epulisov's histologically distinguish:
1) Granulomatous.
The granulation tissue in various stages of the fibrous transformation is noticeably dominated, up to the formation of coarse-fiber granulation tissue.
2) angioatous.
In addition to the elements inherent in the first group (the presence of fibrous and granulation tissue), contains a large number of blood vessels.
3) gianthell.
They are connecting formations with a large number of giant multi-core cells. However, these cells do not possess atypical growth and, overcoming a certain cycle of development, turning a contemporary community-based (fibrous tissue).
Pathological anatomy
The outer surface of the epulis is covered with epithelium, often a rather thick layer. The tumor consists of elements connective tissue and blood vessels. The overall histological characteristics lies in the absence of atyphen cells and the gradual transition of the tumor into fibrous mature fabric.
Clinic
Fibrous epulisses have a density consistency, round or oval shape. The surface of their smooth or steepobugrous. Usually they are located on a wide base, but may also have a pronounced leg. Mucous membrane covering epulis, pale pink color. The growth of their very slow, significant sizes are rarely achieved.
Angiomatous epulis is localized mainly in the side departments of jaws. The growth of soft tissues of the gums has a bright red color with a cyanotic tinge, a soft-elastic consistency. The surface of epulisa in most cases is fine-minded, less frequently smooth. Character. A feature of this type of tumor is the easiest bleeding (even with the slightest touch), having often pulsating character. Epuls are growing relatively quickly and prone to relapses, especially during pregnancy.
Gigantaeer epulis has a rounded, less often an ellipse form, a smooth surface, a soft or elastic-elastic consistency, a dark red color, more often a consistency, a dark red color, more often with a pronounced brown tint. Possessing progressive growth can reach large sizes. They are painless, moderately bleeding during injury. Sometimes on the surface of epulis, you can see the prints of antagonist teeth.
Diagnostics
The diagnosis is made on the basis of the data of the clinic and the results of histological research.
Differential diagnosis
It is necessary to differentiate with hypertrophic gingivitis, which is the growth of the gum papilla. The source tissue of epulis in one in some cases is the pericient of the tooth or the perception of the alveoli, in others - the endoost and bone marrow of the spongy wall of the alveoli wall.
Treatment
The treatment consists in excision of epulis within the limits of healthy tissues with the destruction of the growth zone. Often you have to remove intact teeth in the localization area of \u200b\u200bthe tumor.
