Epulises: current problem

Abstract

Relevance. Nowadays an important problem in dentistry is the early diagnosis and the treatment of tumors and tumor-like lesions. One of the most frequent lesions of the orofacial region, and particularly of the periodontium, is a non-tumor lesion called epulis. Some tumors and tumor-like lesions may be both clinically and histologically similar, hence the diagnosis and the differential diagnosis of the epulis is still complicated and need to pay attention. Moreover, every type of epulis has particular histological features that make a clinician use a specific treatment in each clinical case. The treatment success and the necessity of the further observations are determined by the correct diagnosis. However, there is still controversial data about epulis diagnosis. Moreover, the reliable criteria for correct diagnosis of each type of epulis have not been discussed yet.Purpose. The aim of this study is to determine the most relevant methods for differential diagnosis of every type of epulis and other tumor and tumor-like lesions of the alveolar ridge with the same clinical and histological descriptions was performed.Materials and methods. In this article the review of the literature is presented. A comprehensive literature search of the studies from 1970 through 2019 in PubMed database regarding the epulis and other tumor and tumor-like lesions with the same clinical and histological descriptions was performed. 71 relevant articles were selected.Results. “Epulis” is a term that refers to tumor and tumor-like lesions of the alveolar ridge. Due to their morphological features it is frequently necessary to carry out not only the histological studies but also use immunohistochemical and genetic analyses. It is not complicated to verify vascular epulis and fibrous epulis. If there is a plasma-cell infiltration of fibrous epulis stroma, clinician is to differ it from IgG4-assosiated diseases. In some cases to discern pyogenic granuloma and hemangioma it is necessary to carry out immunohistochemical study of the blood vessel wall components. It is also important to know diagnostics of giant-cell epulis. Here to divide peripheral and central giant-cell granulomas genetic analysis should be carried out.Conclusion. Usually microscopic study of fibrous and vascular epulis helps to differentiate it with other lesions. The IgG4associated diseases are to exclude by immunohistochemical study. Diagnostics of giant-cell epulis may include both immunochemical and genetic studies. Methods presented in this article are important both for treatment and for prognosis of the disease.