Recent investigations regarding the pathogenesis of epulis

Abstract

According to the author's investigations, the epulis has to be considered as a granulation tissue derived from the elements of the parodontium. Etiological factors are changes of the bony tissue caused by resorptive processes. There are two clinical types of epulis: 1. 1. Spongy granulation tissue with indistinct outlines in the vicinity of badly decayed teeth, accompanied by symptoms of chronic inflammation of the gingiva. 2. 2. Circumscript neoplasm in the neighborhood of healthy teeth. The histologic structure is characterized by the presence of fibroblasts, an extracellular fibrous network, and giant cells. Shape and staining of the giant cells resemble closely those of the osteoclastic cells and may be considered as signs of resorptional disturbances. The giant cells are derived from the cells of the periosteal connective tissue and the perivascular tissue. In the granulative form of epulis, a process of maturation is to be observed; giant cells appear in the immature vascularized granulation tissue and disappear later, being replaced by fibrous cicatricial tissue, after the resorptive process has been finished. The solid form of epulis has to be considered as a tumor of the resorptive connective tissue of the bone and may be termed osteoclastoma.