MANAGEMENT OF SUSPECT GRANULOMATOUS EPULIS OF ANTERIOR MANDIBULAR TEETH WITH GINGIVECTOMY

Abstract

ABSTRACT 

Gingival enlargement is a manifestation of hypertrophy (increase in cell size) and hyperplasia (increase in cell number). Epulis is a gingival hyperplasia (tumor-like) that originates from periodontal connective tissue. One type of epulis that often occurs is granulomatous epulis. Granulomatous epulis is a type of epulis that occurs from a granulomatous tissue reaction due to chronic irritation due to calculus, root residues, or carious edges. This case report discusses the management of suspect epulis granulomatous in mandibular anterior teeth. A 45-year-old female patient complained of swollen lower front gums and frequent bleeding when brushing her teeth. Intraoral examination showed that there was gingival enlargement in the form of papules with a size of 6 mm x 8 mm, reddish in color, smooth surface, soft consistency, well demarcated, painless but bleeding on palpation in the tooth area 41. OHI score 4.9 (moderate), BOP ( Bleeding in probing) was positive, and the probing depth of the mesiolabial, midlabial, and distolabial surfaces i.e. for tooth 41 was 5-5-5. The diagnosis in this case led to suspect epulis granulomatous on tooth 41. The treatment plan was KIE (Communication, Information and Education), initial therapy in the form of scaling and root planing, gingivectomy and then control. The results of the treatment showed that the gingival contour was physiologically formed, there was no swelling, negative palpation, negative BOP, and decreased pocket depth from the mesiolabial, midlabial, and distolabial surfaces of tooth 41 to 2-2-3.

Keywords: epulis, granulomatous epulis, gingivectomy, gingival enlargement