Treatment of epulis fissuratum with carbon dioxide laser

Abstract

Introduction Epulis fissuratum is a pseudotumor growth located over the soft tissues of the vestibular sulcus caused by chronic irritation from poorly adapted prostheses. The definitive treatment is excision with appropriate prosthetic reconstruction. The use of laser carbon dioxide (CO2) in the treatment of these lesions presents many advantages over conventional surgery including surgical technique without direct contact with tissue, without bleeding or need for sutures, minimal postoperative pain and edema. The haemostatic capacity of CO2 laser is describe widespread being a usefull instrument for oral surgery in patients that suffered from clotting disorders. Objective The aim of this article is to present a case of epulis fissuratum in a patient with antithrombotic medication demonstrating the usefulness of the CO2 laser for treatment of this lesion. Case report We present a case of a 72 years-old female, referred to Hospital Nossa Senhora da Conceição de Valongo, Porto, with growth of vestibular oral mucosa in the mandible and maxilla associated with ill-fitting prostheses, suggestive of epulis fissuratum. She was taking antithrombotic medication. These lesions were excised with CO2 laser. Three weeks after surgery, both areas were completely reepithelizaded. No significant complications were recorded as hemorrhage, pain, swelling or infection. Prosthetic rehabilitation and function were achieved with the fabrication of new upper and lower dentures. The patient was seen a month and 1 year after treatment lying free of recurrence. Conclusion The use of CO2 lasers are nowadays the Gold Standard in the excision of this type of pathology especially in patients with hemorrhagic diathesis or antithrombotic therapy.