A large-cohort study of 2971 cases of epulis: focusing on risk factors associated with recurrence

Abstract

Background To analyze the clinicopathological features of different histological subtypes of epulis, and evaluate the risk factors associated with recurrence. Materials and methods A retrospective study including 2971 patients was performed. The patients’ sex, age, location, size, histological subtypes, recurrence information, oral hygiene habits, periodontitis symptoms and smoking history were retrieved from the patient medical records and follow-up information. Results Among the 2971 cases, focal fibrous hyperplasia (FFH) was the most common lesion (60.92%), followed by peripheral ossifying fibroma (POF) (29.32%), pyogenic granuloma (PG) (8.08%) and peripheral giant cell granuloma (PGCG) (1.68%). The peak incidence of epulis was in the third and fourth decade of life, with a mean age of 45.55 years. Female predominance was found in all types of lesions with a female to male ratio of 1.71:1. PG had the highest recurrence rate (17.18%), followed by POF (12.98%), FFH (9.55%) and PGCG (8.82%). Histological subtypes were significantly correlated with the recurrence of epulis (P = 0.013). Regular supportive periodontal therapy (P = 0.050) had a negative correlation with recurrence, whereas symptoms of periodontitis (P < 0.001) had a positive correlation with the recurrence of epulis. Conclusions Controlling the periodontal inflammation and regular supportive periodontal therapy might help reduce the recurrence of epulis.

Management of hormonal induced recurrent ulcerative fibrous epulis with osseous metaplasia: A case report

“…Most cases of pregnancy‐related gingival overgrowth would resolve fully or reduce in size after 6–8 weeks postpartum 29,41 . Zhao et al reviewed 2917 cases of fibrous epulis and reported an average recurrence rate of 11.28% with pregnancy‐related lesions having the highest recurrence rates 42 . Furthermore, Zhao et al concluded that regular periodontal supportive therapy and management of the periodontal inflammation had a significant impact in reduction the recurrence rates 42 .…”

“… 29 , 41 Zhao et al reviewed 2917 cases of fibrous epulis and reported an average recurrence rate of 11.28% with pregnancy‐related lesions having the highest recurrence rates. 42 Furthermore, Zhao et al concluded that regular periodontal supportive therapy and management of the periodontal inflammation had a significant impact in reduction the recurrence rates. 42 This emphasizes the point raised in the current case report where local periodontal debridement should have been performed after the first excisional biopsy in order to reduce the chances of recurrence.…”

“… 42 Furthermore, Zhao et al concluded that regular periodontal supportive therapy and management of the periodontal inflammation had a significant impact in reduction the recurrence rates. 42 This emphasizes the point raised in the current case report where local periodontal debridement should have been performed after the first excisional biopsy in order to reduce the chances of recurrence. After the recurrence of the lesion in 3 months, no further recurrence was reported after following up the case for 2 years.…”

Oral Reactive Hyperplastic Lesions: Prevalence in Egypt and Proposal of Novel Classification System

“…Regardless of the variable used terminologies, most of the previous studies have agreed with our nding that irritational broma is the most prevalent (40%). However, they reported different percentages 57.4%(Reddy et al, 2012), 69.3%(Vidyanath et al, 2015), 47%(Babu and Hallikeri, 2017), 37.4%(Sangle et al, 2018), 72.09%(Dutra et al, 2019) and 61%(Zhao et al, 2023). On the contrary, few research showed that pyogenic granuloma is the most common ORHL, followed by irritational broma(Kashyap et al, 2012 andKadeh et al, 2015).In line with our results, Naderi et al (2012), Reddy et al, (2012), Babu and Hallikeri (2017) and Dutra et al (2019) have shown that pyogenic granuloma is…”