Etiology and Management of Inflammatory Papillary Hyperplasia in Completely Edentulous Patients - A Review

Abstract

Oral mucosa of complete denture wearing patients is subjected to varying amount of stresses as compared to patient having natural teeth. This can leads to different type of oral mucosal lesions like denture stomatitis, epulis fissuratum, angular cheilitis, traumatic ulcers, inflammatory papillary hyperplasia (IPH) etc. IPH is a type of chronic inflammatory proliferative lesion characterized by numerous small, wart like edematous red papillary growth most commonly seen in deepest part of the palate. Review of literature suggest denture associated widely distributed etiology for IPH like over accentuation of palatal relief and vacuum chamber in upper denture, old ill fitting dentures, poor denture hygiene, continuous denture wearing habit, faulty occlusion, skidding of instable denture etc. Treatment for IPH varies with the severity of the condition and may range from conservative to surgical depending on clinical presentation. Conservative approach include discontinuing use of ill fitting denture, correction of faulty prostheses, improving the oral and denture hygiene and antifungal drugs. However, the surgical approach is used when the lesion is more aggressive and this include supraperiosteal excision, resesctive surgery, cryotherapy, and electrosurgery, blade-loop surgery, fulguration, and mucoabrasion or laser surgery. As a method of prevention patient should be advised to avoid continuous day and night wearing of denture. Additionally, avoid providing excessive relief in the palatal region, as these areas become site for bacterial and fungal colonization. Patients should be well motivated for proper care and maintenance of denture hygiene and also for the importance of periodic dental visits and follow-ups.