Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2025; 13(21): 106413
Published online Jul 26, 2025. doi: 10.12998/wjcc.v13.i21.106413
Multidisciplinary treatment of epulis fissuratum: A case report
Luis Antonio González Gómez, Nora Esther Guedea Preciado, Melissa Martínez Nieto, Ruth Rodríguez Montaño, Mario A Alarcón-Sánchez, Erandis D Torres-Sánchez, Juan Carlos Gómez Mireles, Elizabeth Acevedo Ambriz, Sarah M Lomelí Martínez
Luis Antonio González Gómez, Nora Esther Guedea Preciado, Melissa Martínez Nieto, Juan Carlos Gómez Mireles, Elizabeth Acevedo Ambriz, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara (CUCS-UdeG), Guadalajara 44340, Jalisco, Mexico
Ruth Rodríguez Montaño, Department of Health and Illness as an Individual and Collective Process, University Center of Tlajomulco, University of Guadalajara (CUTLAJO-UdeG), Tlajomulco de Zuñiga 45641, Jalisco, Mexico
Ruth Rodríguez Montaño, Mario A Alarcón-Sánchez, Institute of Research in Dentistry, Department of Integral Dental Clinics, University Center of Health Sciences, University of Guadalajara (CUCS-UdeG), Guadalajara 44340, Jalisco, Mexico
Mario A Alarcón-Sánchez, Department of Molecular Biology and Medicine, Molecular Biology, University Center of Health Sciences, University of Guadalajara (CUCS-UdeG), Guadalajara 44340, Jalisco, Mexico
Erandis D Torres-Sánchez, Sarah M Lomelí Martínez, Department of Medical and Life Sciences, La Ciénega University Center, University of Guadalajara (CUCIENEGA-UdeG), Ocotlán 47810, Jalisco, Mexico
Sarah M Lomelí Martínez, Department of Well-being and Sustainable Development, University Center of the North, University of Guadalajara (CUNORTE-UdeG), Colotlan 46200, Jalisco, Mexico
Co-corresponding authors: Erandis D Torres-Sánchez and Sarah M Lomelí Martínez.
Author contributions: González Gómez LA, Guedea Preciado NE, and Lomelí Martínez SM contributed to the diagnosis, surgical treatment, and management of the patient; Martínez Nieto M, Rodríguez Montaño R, Alarcón-Sánchez MA, and Torres-Sánchez ED contributed to the acquisition and analysis of data; González Gómez LA, Guedea Preciado NE, Lomelí Martínez SM, Martínez Nieto M, Rodríguez Montaño R, and Alarcón-Sánchez MA drafted the manuscript and critically revised the manuscript; Gómez Mireles JC, Acevedo Ambriz E, González Gómez LA, Torres-Sánchez ED, and Lomelí Martínez SL contributed to the conceptualization and supervision of the study; Torres-Sánchez ED and Lomelí Martínez SM contributed equally as co-corresponding authors; All authors have read and approved the final manuscript.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sarah M Lomelí Martínez, PhD, Adjunct Associate Professor, Department of Medical and Life Sciences, La Ciénega University Center, University of Guadalajara (CUCIENEGA-UdeG),1115 Universidad Avenue, Colonia Lindavista, Ocotlán 47810, Jalisco, Mexico. sarah.lomeli@academicos.udg.mx
Received: February 26, 2025
Revised: March 21, 2025
Accepted: April 3, 2025
Published online: July 26, 2025
Processing time: 61 Days and 2.5 Hours
Abstract
BACKGROUND

Epulis fissuratum is an inflammatory fibrous hyperplasia characterized by pseudotumoral growth in the soft tissues of the oral mucosa. It is a multifactorial condition caused by factors such as poor oral hygiene, prolonged use of ill-fitting dentures, continuous use of dentures without intervals of rest, and underlying systemic conditions such as diabetes mellitus and coagulation disorders. Although initially asymptomatic if left untreated, the lesion may result in complications such as ulcerations, secondary infections, and interference with speech, masticatory function, and oral aesthetics with significant adverse impact on the patient.

CASE SUMMARY

A 56-year-old female patient with no significant medical history presented to the dental clinic with tissue overgrowth and depression of the upper lip. She reported 30 years of continuous use of a complete maxillary denture without ever removing it. The management of this condition required a multidisciplinary approach to ensure accurate diagnosis and a strategic treatment plan tailored to her systemic health and the severity of the oral condition. The diagnosis of epulis fissuratum was confirmed through histopathological analysis. Treatment was implemented in two phases: Surgical and prosthetic. The surgical phase involved excision of the excess tissue and placement of a free gingival graft in the anterior maxillary vestibular area in order to deepen the vestibule and optimize the ridge for prosthetic rehabilitation. The prosthetic phase involved fabrication and placement of a new complete denture.

CONCLUSION

The multidisciplinary management of epulis fissuratum resulted in precise clinical diagnosis, effective soft tissue management, and appropriate prosthetic adjustments, thereby ensuring favorable long-term outcomes for the patient.

Keywords: Epulis fissuratum; Hyperplasia; Oral pathology; Soft tissue lesion; Case report

Core Tip: The present clinical case described the multidisciplinary management of a patient with epulis fissuratum developed after 30 years of continuous use of a complete maxillary prosthesis without removal. The treatment was carried out in two phases: Surgical and prosthetic. In the surgical phase, the hyperplastic tissue was removed, and a vestibuloplasty with free gingival graft was performed. The prosthetic phase involved the fabrication of new complete prostheses to restore oral function and aesthetics. The comprehensive treatment, which combined surgical techniques and correct prosthetic rehabilitation, guarantees favorable long-term results.