non neoplastic mucosal swelling - Giant cell granuloma, epulis fissuratum

Denture-induced granuloma, also known as inflammatory papillary hyperplasia, is a condition that can occur in the oral mucosa in response to wearing ill-fitting or improperly maintained dentures. It is a common oral lesion seen in denture wearers, particularly those who do not remove their dentures regularly or clean them properly. Here's an overview of denture-induced granuloma:

Causes:

Denture-induced granuloma is primarily caused by chronic irritation and trauma to the oral mucosa due to ill-fitting dentures. Factors that contribute to its development include:

1. Continuous wearing of dentures without allowing sufficient rest periods for the oral tissues to recover.

2. Poorly fitting dentures that exert pressure on specific areas of the oral mucosa.

3. Accumulation of plaque and debris on the denture surface, leading to local inflammation.

Symptoms:

Denture-induced granuloma typically presents as painless, pink to red, raised, and granular-looking lesions in the areas where the denture rests against the oral tissues. The most common sites affected are the palate (hard and soft), the alveolar ridge, and the buccal vestibule. In some cases, the lesions may become ulcerated or secondarily infected.

Diagnosis:

Diagnosing denture-induced granuloma is based on clinical examination and a patient's history of denture use. A biopsy may be performed to confirm the diagnosis and rule out other potential causes of oral lesions.

Treatment:

The mainstay of treatment for denture-induced granuloma involves improving denture fit and oral hygiene. This may include:

1. Adjusting or relining the denture to alleviate pressure points on the oral mucosa.

2. Providing patients with instructions for proper denture cleaning and care.

3. Encouraging regular removal of dentures to allow oral tissues to rest and heal.

4. Treating any secondary infections, if present.

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In some cases, the lesions may resolve with conservative management. However, persistent or severe cases may require surgical excision of the granulomatous tissue.

Prevention:

Preventing denture-induced granuloma involves proper denture care and regular follow-up with a dentist. It is essential for denture wearers to have their dentures checked periodically for fit and function and to maintain good oral hygiene.

If a denture wearer notices any oral lesions, discomfort, or changes in their oral tissues, they should seek prompt evaluation and care from a dental professional. Early intervention can help prevent the progression of the condition and promote oral health and well-being.

Peripheral Giant Cell Granuloma (PGCG) and Central Giant Cell Granuloma (CGCG) are two distinct types of benign, non-neoplastic lesions that occur in the oral and maxillofacial region. While they share some similarities, they have different clinical presentations, locations, and behavior. Here's an overview of each:

1. Peripheral Giant Cell Granuloma (PGCG):

Location: PGCG occurs on the soft tissues of the oral cavity, typically on the gingiva (gums) and alveolar mucosa. It is more common in the anterior (front) region of the mouth.

Clinical Presentation: PGCG presents as a red or reddish-purple, sessile or pedunculated mass that can be ulcerated. It is often associated with trauma or irritation, such as ill-fitting dentures or poor oral hygiene.

Behavior: PGCG is considered a reactive lesion rather than a true neoplasm. It has a tendency to grow slowly and is less invasive than Central Giant Cell Granuloma.

2. Central Giant Cell Granuloma (CGCG):

Location: CGCG occurs within the bone of the maxillofacial region, primarily in the mandible (lower jaw) and occasionally in the maxilla (upper jaw). It can be either central, originating from the bone, or peripheral, arising from the periosteum (tissue covering the bone).

Clinical Presentation: CGCG presents as a painless, non-ulcerated swelling of the affected bone. On radiographic imaging, it appears as a well-defined, radiolucent (dark) area with scattered radiopaque (white) areas within it.

Behavior: CGCG is also considered a reactive lesion but has a more aggressive behavior compared to Peripheral Giant Cell Granuloma. It can cause bone expansion and destruction, leading to a weakening of the affected jawbone.

Treatment:

- Peripheral Giant Cell Granuloma: The treatment of choice is surgical excision. Complete removal of the lesion is usually curative, with a low recurrence rate.

- Central Giant Cell Granuloma: The treatment depends on the size and behavior of the lesion. Surgical curettage (scraping of the lesion) is often performed for smaller lesions. Larger or aggressive lesions may require more extensive surgical procedures, such as enucleation or resection. Recurrence rates for CGCG can be higher compared to PGCG.

It is crucial for individuals who notice any oral or maxillofacial swellings or lesions to seek evaluation and care from a dental or medical professional. Accurate diagnosis and appropriate management are essential to ensure the best possible outcome for individuals with Peripheral and Central Giant Cell Granuloma.

Certainly! Here are 10 multiple-choice questions (MCQs) on the topic of Peripheral and Central Giant Cell Granuloma:

1. Peripheral Giant Cell Granuloma (PGCG) occurs in which region of the oral cavity?

   a) Tongue

   b) Gingiva (gums)

   c) Palate

   d) Pharynx

2. Central Giant Cell Granuloma (CGCG) most commonly affects which jawbone?

   a) Maxilla (upper jaw)

   b) Mandible (lower jaw)

   c) Temporal bone

   d) Zygomatic bone

3. What is the primary difference between PGCG and CGCG?

   a) Location of occurrence

   b) Color of the lesion

   c) Pain associated with the lesion

   d) Presence of ulceration

4. The rapid growth of PGCG is often associated with:

   a) Dental caries

   b) Hormonal changes during pregnancy

   c) Cigarette smoking

   d) Orthodontic treatment

5. Radiographically, CGCG appears as a well-defined, __________ area with scattered radiopaque (white) areas within it.

   a) Radiolucent (dark)

   b) Radiopaque (white)

   c) Erosive

   d) Ulcerated

6. Treatment of choice for PGCG is:

   a) Systemic corticosteroids

   b) Chemotherapy

   c) Surgical excision

   d) Radiation therapy

7. CGCG can cause bone expansion and destruction, leading to:

   a) Strengthening of the jawbone

   b) Weakening of the jawbone

   c) Formation of new bone tissue

   d) Osteoporosis

8. What is the origin of PGCG?

   a) Blood vessels

   b) Nerve tissue

   c) Salivary glands

   d) Bone tissue

9. Which of the following is true about PGCG?

   a) It is a malignant tumor

   b) It has a high recurrence rate after surgical removal

   c) It occurs exclusively in children

   d) It is caused by a viral infection

10. Surgical curettage is commonly performed for the treatment of:

    a) PGCG

    b) CGCG

    c) Both PGCG and CGCG

    d) Neither PGCG nor CGCG

Answers:

1. b) Gingiva (gums)

2. b) Mandible (lower jaw)

3. a) Location of occurrence

4. b) Hormonal changes during pregnancy

5. a) Radiolucent (dark)

6. c) Surgical excision

7. b) Weakening of the jawbone

8. a) Blood vessels

9. b) It has a high recurrence rate after surgical removal

10. c) Both PGCG and CGCG

Note: This test is for educational purposes only and should not be used for medical diagnosis. Always consult a qualified healthcare professional for accurate diagnosis and appropriate management of Peripheral and Central Giant Cell Granuloma.

Congenital epulis, also known as congenital granular cell tumor or Neumann's tumor, is a rare benign soft tissue tumor that occurs in newborns. It is a type of granular cell tumor and is notable for its presence at birth, hence the term "congenital." Here's an overview of congenital epulis:

Incidence and Location:

Congenital epulis is a very rare condition, with a prevalence of about 1 in 10,000 to 100,000 live births. It occurs almost exclusively in newborn females. The tumor typically arises from the alveolar ridge of the newborn's mouth, most commonly involving the gum area of the maxilla (upper jaw). It is usually a single tumor, and in some cases, it can be found in the tongue or other oral soft tissues.

Clinical Presentation:

Congenital epulis is characterized by its appearance as a soft, pink to red, pedunculated (stalk-like) or sessile (flat-based) mass. The tumor is usually well-circumscribed and non-ulcerated. It may vary in size but is generally small, ranging from a few millimeters to several centimeters in diameter.

Histopathology:

Microscopically, congenital epulis is composed of granular cells, which are large, round cells with abundant granular cytoplasm. The tumor is typically encapsulated and shows well-defined borders. It is considered a benign tumor and does not metastasize to other parts of the body.

Treatment:

The primary treatment for congenital epulis is surgical excision. Surgical removal of the tumor is typically curative, and recurrence is rare. The tumor is removed with a margin of healthy tissue to ensure complete removal and prevent regrowth.

Prognosis:

The prognosis for congenital epulis is excellent, as it is a benign tumor and does not pose significant health risks. After surgical excision, the newborn's mouth heals well, and long-term complications are uncommon.

It's essential for parents and caregivers to seek prompt medical evaluation if they notice any unusual oral masses or growths in a newborn's mouth. A pediatrician or pediatric dentist can provide an accurate diagnosis and recommend appropriate management, typically through surgical removal of the congenital epulis.