RESUMO
Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted dentures. Treatment indication for these lesions is surgical excision with appropriate prosthetic reconstruction. The hemostatic capacity of carbon dioxide (CO(2)) laser is well described in the literature as a useful tool in oral surgery, especially in patients with clotting disorders. This paper presents a case of a 72-year-old female patient referred to the 'Nossa Senhora da Conceição de Valongo Hospital' at Porto, Portugal, with a massive growth of vestibular oral mucosa in the mandible and maxilla associated with ill-fitting dentures, suggestive of epulis fissuratum. The patient was taking antithrombotic medication. The lesions were excised with CO(2) laser, and no significant complications, such as hemorrhage, pain, swelling or infection, were recorded. Twenty days after surgery, both areas were completely reepithelizaded. Prosthetic rehabilitation and function were achieved with the fabrication of new maxillary and mandibular dentures. Follow-up 1 month and 1 year after treatment revealed the areas free of recurrence. The use of CO(2) lasers is currently the gold standard in the excision of this type of lesion, especially in patients with hemorrhagic diathesis or under antithrombotic therapy.
Assuntos
Dentaduras/efeitos adversos , Doenças da Gengiva/cirurgia , Lasers de Gás/uso terapêutico , Mandíbula/cirurgia , Maxila/cirurgia , Idoso , Feminino , Fibrinolíticos/uso terapêutico , Doenças da Gengiva/etiologia , Humanos , Cirurgia Bucal/métodosRESUMO
Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted dentures. Treatment indication for these lesions is surgical excision with appropriate prosthetic reconstruction. The hemostatic capacity of carbon dioxide (CO2) laser is well described in the literature as a useful tool in oral surgery, especially in patients with clotting disorders. This paper presents a case of a 72-year-old female patient referred to the 'Nossa Senhora da Conceição de Valongo Hospital' at Porto, Portugal, with a massive growth of vestibular oral mucosa in the mandible and maxilla associated with ill-fitting dentures, suggestive of epulis fissuratum. The patient was taking antithrombotic medication. The lesions were excised with CO2 laser, and no significant complications, such as hemorrhage, pain, swelling or infection, were recorded. Twenty days after surgery, both areas were completely reepithelizaded. Prosthetic rehabilitation and function were achieved with the fabrication of new maxillary and mandibular dentures. Follow-up 1 month and 1 year after treatment revealed the areas free of recurrence. The use of CO2 lasers is currently the gold standard in the excision of this type of lesion, especially in patients with hemorrhagic diathesis or under antithrombotic therapy.
Epulis fissuratum é um crescimento pseudotumoral localizado sobre os tecidos do sulco vestibular causada por irritação crônica de próteses mal adaptadas. O tratamento indicado para estas lesões é a sua excisão cirúrgica com reabilitação protética apropriada. A capacidade hemostática do laser de dióxido de carbono (CO2) está amplamente descrita na literatura como instrumento útil em procedimentos cirúrgicos especialmente em pacientes que sofrem de distúrbios de coagulação. Este artigo apresenta um caso de uma paciente do sexo feminino de 72 anos, enviada ao Hospital Nossa Senhora da Conceição de Valongo, Porto, Portugal, que apresentou-se com crescimentos exuberantes das mucosas vestibular maxilar e mandibular associados a próteses mal adaptadas. A paciente estava sob uso de medicação anti-trombótica. As lesões foram excisadas com laser de CO2. Não foram reportadas complicações significativas como hemorragia, dor, tumefação ou infecção. Vinte dias após a cirurgia, ambas as áreas encontravam-se completamente reepitelizadas. A reabilitação protética foi promovida com a produção de novas próteses superior e inferior. O acompanhamento após 1 mês e 1 ano não mostrou evidências de recidiva. A utilização do laser CO2 é nos nossos dias a técnica de eleição na excisão deste tipo de lesões especialmente em pacientes com diáteses hemorrágicas ou terapia anti-trombótica.