Microsurgical repair of labial gingival tissues following excision of an epulis: a case report with 18‐month follow‐up

Abstract

The purpose of this study was to describe an alternative surgical approach to simply removing an epulis: The methodology was to both preserve and improve the mucogingival complex. After supportive periodontal therapy that included oral hygiene instruction, scaling and root planning, the patient underwent surgical treatment to remove the tumour. A subepithelial connective tissue graft together with a lateral mucogingival pedicle flap was used to repair the extensive defect.

L’innesto connettivale nel trattamento chirurgico dell’epulide: caso clinico

“…In letteratura ci sono poche informazioni inerenti la gestione di deficit gengivali causati dalla rimozione di masse gengivali localizzate [9,10] .…”

“…Recentemente, McCrea ha descritto un approccio chirurgico alternativo per trattare il difetto gengivale residuo conseguente all'asportazione di un'epulide [9] ; nel dettaglio, è stato utilizzato un innesto FEBBRAIO/2019 DENTAL CADMOS plachia orale [11] .…”

Periodontal plastic procedure for the management of the residual gingival defect after excision of an epulis

“…McCrea reported a case where microsurgical repair of labial gingival tissues was done following excision of epulis and results were maintained at 18 month follow-up. [ 5 ] In our case, because lesion was in the anterior region, so it was decided to do incisional biopsy first to confirm the nature of the growth and subsequent planning for simultaneous removal of the lesion and connective tissue grafting. Complete root coverage was seen at 6 months follow-up.…”

“…Recently, McCrea described an alternative surgical approach to simply removing an epulis. [ 5 ] A subepithelial connective tissue graft together with a lateral mucogingival pedicle flap was used to repair the extensive defect after excision of the lesion to preserve and improve the mucogingival complex. Various different PPS techniques may be used to manage this defect and minimize patient esthetic concerns.…”

The “Washing Line” Suture Technique for Securing the Subepithelial Connective Tissue Graft

“…Preparation of the recipient site is to maximize blood supply for blood clot formation and organization to prevent graft necrosis while minimizing mobility to prevent tearing of the delicate blood vessels that will invade the graft and cause neovascularization.'' 19 The inability to achieve neovascularization is the causative factor for graft sloughing and the failure or diminishment in attainment of optimal results. Therefore, immobilization of the CT graft and primary closure of the wound are prerequisites for optimization of the results.…”