The connective tissue graft in the surgical treatment of epulis: a clinical case

OBJECTIVES Epulis is an asymptomatic lesion and its election treatment consists in the surgical excision that often produces important esthetic and functional alterations of the gingival complex. The purpose of this case report is to describe an alternative surgical approach to remove an epulis while preserving and improving the aesthetics of the much-gingival complex. MATERIALS AND METHODS A 29-years-old patient was referred for the evaluation of a hyper plastic gingival lesion localized on the buccal aspect of the upper central incisors. The histologic diagnosis was of pyogenic granuloma. After initial periodontal therapy and labial frenectomy, the patient underwent surgical treatment. A sub-epithelial connective tissue graft was interposed between a full-thickness muco-periosteal flap and the recipient bed, preserving the lesion. RESULTS AND CONCLUSIONS No post surgical complications were detected. More than a one year after surgery the patient exhibited no epulis with a stable gingival situation and no recurrence was detected. This technique seems to be able to remove the lesion and allow a thickness increase of the connective tissue underlying the mass, preventing post surgical gingival recessions and retraction scars and avoiding a second surgical reconstructive procedure.