Inflammatory papillary hyperplasia

Inflammatory papillary hyperplasia (also termed palatal papillomatosis,[1] palatal epithelial hyperplasia,[2] and denture papillomatosis),[3] is a hyperplasia (overgrowth) of soft tissue, usually beneath a denture. It is associated with poor denture hygiene, denture overuse, and ill-fitting dentures.

It is a closely related condition to inflammatory fibrous hyperplasia (epulis fissuratum), but the appearance and location differs.[3]

Signs and symptoms

It appears as an asymptomatic erythematous area, usually the hard palate, with a pebbly surface.

Etiology

The exact cause of inflammatory papillary hyperplasia is unknown, but it is thought to be a reactive, inflammatory lesion in response to irritation from an upper dental prosthesis. Nonetheless, it may also occur on the hard palates of patients who are chronic mouth-breathers. Sometimes, this disease can found in conjunction with another denture-related disease, an epulis fissuratum.

The appearance of an epulis fissuratum microscopically is an overgrowth of stratified squamous epithelium cells. Depending on the how advanced the condition is, pseudoepitheliomatous hyperplasia may be present.

In mild cases, treatment consists of removal of the denture with spontaneous regression of the disease. In advanced cases of inflammatory papillary hyperplasia, surgery may be needed, along with behavioral modification toward proper denture use.

Epidemiology

Due to the strong association with denture-wearing, the lesion tends to occur more in adults than children. There is no gender predilection.[1] In people who wear dentures 24 hours a day, its incidence is around 20%.

References

  1. 1 2 Rajendran A; Sundaram S (10 February 2014). Shafer's Textbook of Oral Pathology (7th ed.). Elsevier Health Sciences APAC. p. 541. ISBN 978-81-312-3800-4.
  2. Ghom AG; Ghom SA (30 September 2014). Textbook of Oral Medicine. JP Medical Ltd. pp. 305–306. ISBN 978-93-5152-303-1.
  3. 1 2 Barnes L (2009). Surgical pathology of the head and neck, vol. 1 (3rd ed.). New York: Informa Healthcare. pp. 220–221. ISBN 978-0849390234.


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