Epulis

epulis photo
Epulis in the field of the alveolar process of the mandible (right)

Epulis (nudesave) is a benign tumor growth arising on the alveolar ridge jaw, often in the small teeth.
Etiology - long irritation of mucous membrane, hormonal changes (pregnancy). There are usually at the age from 25 to 40 years.
EPolicy can have the size from a few millimeters to 2-3 cm and more in diameter, they are often located from the side of atrium of mouth cavity (Fig.).
Painting Apulia can match the color of the gum, but more often reddish-brown, brown, blue. Sometimes the surface of Apulia ulcerated, which is generally associated with permanent injury (sharp edge of the tooth prosthesis).
Epulis usually has a mushroom shape, is located on the foot, sometimes on a broad basis, at a palpation be certain offset, can be mild or quite firm to the touch; it grows slowly, the pain is. Teeth in the field of Apulia sometimes mobile, slightly offset. On the radiograph shows the rarefaction of bone at the base of Apulia.
Operative treatment, removal of Apulia carried out in the form of excision, some distance 2-3 mm around the leg to the bone.
Softened areas scrape the bones sharp spoon or drill forest. Destruction of adjacent teeth shown only when major changes in the bones.

Epulis (epulis, from the Greek. epi - on and oulon - gum) - tumorous tissue growth, ranging in area of alveolar process of the jaws. Epulis may come from the tissues of the alveolar ridge, at least - body jaw. The group of epulises unite heterogeneous in etiological and morphology of education.
On the basis of clinical, histological and histochemical studies are distinguished: tumor ePolicy type of fibroids, angiomas, osteoblastoklastomy and tumor-like growths (epulis inflammatory and hormonal nature).
Epulis type fibroids are characterized histologically by a large number olokaonyango located bundles of collagen fibers with a small number stretched between them fibroblasts. Histochemically in these abolish find a large number of neutral mucopolysaccharides, located along the beams of collagen fibers. The content of acid mucopolysaccharides are insignificant.
EPolicy type angioma histologically appear pronounced proliferation of blood capillaries, and huge presence of cavities filled with blood or lymph (hemangioma, lymphangioma). Histochemically in these abolish find a small amount of neutral mucopolysaccharides in strips of connective tissue between the vessels. Especially it is characteristic for them great content RNA in the cytoplasm of endothelial cells.
Morphologically ePolicy type osteoblastoklastomy are characterized by the presence of two types of cells (small single-core and large multi-core), cystic cavities and clusters of crystal hemosiderin. Mononuclear cells form the bulk of these apolitov. By its size, shape of the nuclei and cytoplasm they remind young fibroblasts. In these cells often figurines mitoses. Giant multinucleated cells are located in the stroma of Apulia no apparent order. Their dimensions, as well as form, is subject to considerable fluctuations. Areas of concentrations of giant cells surrounded on the periphery of the dense fibrous capsule. Between mononuclear cells of these apolitov is a dense network argyrophilic fibers. By its nature and location of these fibers remind reticulose fiber blood-forming organs. Histochemically in the cytoplasm of giant cells are a large number of RNA. On the theory Century A. Rusakov, development of Apulia type osteoblastoklastomy originates from cells fibrous bone marrow.
Epulis inflammatory and hormonal nature morphologically represent growth of granulation tissue varying degrees of maturity with sharply expressed round-cell infiltration. Histochemically in this group of epulises to find a significant content of acid mucopolysaccharides, and in the ever-present here leukocytes - a large amount of glycogen.
In the epithelial layer covering ePolicy of all types, contains a significant amount of glycogen. Than more apparent submersible growth of the epithelium, the more glycogen.
Clinically ePolicy have more or less pronounced foot, covered with epithelial mucous membranes of the oral cavity, painless, benign, but prone to relapses occur more frequently in women can occur at any age and sometimes for the edentulous jaw (Fig. 1).
EPolicy type fibroids (Fig. 2) represent the tumor solid elastic consistence, light rose color; they are in most cases on a broad basis, not bleed even when major trauma, grow very slowly, over the years, and may be significant. Are mainly periosteal enlargement of collagen tissue.
The surface of Apulia type angioma (Fig. 3)more often bumpy, consistency is soft-elastic, color bluish or purplish-red. The main clinical feature of Apulia this species is their propensity to bleeding even in the slightest trauma and bleeding here is throbbing in nature and difficult to stop. The large size of these ePolicy rarely reach. Radiographically observing changes underlying bone, characteristic for bone angiomas, capillary type.
EPolicy type osteoblastoklastomy (Fig. 4) in most cases are on the top of the alveolar process on a broad basis, have a bluish-purple colour with a brown shade, elastic consistence. Grow relatively quickly and size vary widely. Radiographically here is the rarefaction of bone tissue.
EPolicy inflammatory nature (Fig. 5)as a rule, are located in Mizuno gap in the area of damaged teeth, a poorly made prostheses and seals. Have a hot pink color, soft-elastic consistence. Considerable size rarely reach. On the radiograph see only a small atrophy interdental partitions. EPolicy hormonal nature affect children in the pubertal period and in women during pregnancy (mainly in the second half).
The clinical picture is the same as when abolish inflammatory nature.
Treatment of all types of epulises in most cases, operational and involves removing the tumor within healthy tissue preserving intact, located near Apulia, teeth. In the treatment of Apulia type angioma, in addition to the operations that are applied also sclerosing therapy Bratanova-hinidinovogo mixture. In the treatment of epulises inflammatory nature after excision, especially in cases of relapse, recommended the introduction of hydrocortisone injection (1 ml three times) the transitional fold of the code of atrium of mouth cavity.