Contents
Gum tumors are the old name of a hyperlipidae. Currently, gingival tumors include 4 separate disease entities: pyogenic granuloma, peripheral giant cell granuloma, peripheral fibroma and parulis (gingival abscess). Vascular granuloma is most common in adults, while gingival abscess develops more frequently in children. Vascular granuloma occurs as a result of trauma or during pregnancy, possibly due to a hormonal rebalancing. A gingival abscess develops as a result of a bacterial infection.
Gum tumors
Gum tumors and various types of swelling are common changes in the human mouth. Gum tumors include four disease entities: pyogenic granuloma, peripheral giant cell granuloma, peripheral fibroma, and parulis (gingival abscess). Gum tumors are often detected by the patient himself using the tongue, sometimes they are diagnosed as a result of pain symptoms. New lumps (e.g. on the tongue) should not be ignored as they may be the beginning of cancer. The tumors are most often located around the gums. Peripheral giant cell granuloma occurs most often between the incisors and the first molars, and the abscess – within the periodontal pocket. Treatment of lesions consists in their surgical excision. In the case of an abscess, incision and drainage are indicated, as well as general antibiotic administration. The prognosis is good.
The causes of gum tumors
The most common causes of gum tumors are:
- neoplasms: Kaposi’s sarcoma, tumors of the salivary glands,
- sarcoidosis,
- granulomas,
- periodontal abscesses,
- insect bites,
- injuries as a result of pressing prostheses or hematomas,
- infections,
- changes occurring at the stage of development: lymphangiomas, blood vessels or congenital gingival fibromatosis and impacted teeth,
- pregnancy – often in pregnant women there is swelling of the gums or the formation of gestational epigers,
- taking contraceptive preparations,
- taking certain medications that lead to swelling of the gums, e.g. calcium channel blockers,
- viruses – common warts, papillomas, condylomas,
- choroba Pageta,
- fibrous bone dysplasia.
Types of gum tumors (benign lesions in the mouth)
1. Granulomatous and fibrous epilates – they are spherical bumps of varying consistency. Sometimes they are soft and flexible, and other times they are hard. Their color is only slightly different from the color of the gums, they do not cause any pain. Granulation and fibrous gingival tumors are located only on the gingival mucosa, avoiding deeper tissues (bones). Sometimes large tumors compress the bone and cause it to atrophy, and cause adjacent teeth to move.
2. Giant cell epilepsy – have a soft consistency and not very regular shapes. Giant cell tumors are named after giant cells visible in microscopic examination. These types of tumors have the ability to bleed even with minor injuries because they are very well vascularized. Moreover, they frequently recur and are associated with a high risk of developing into a malignant neoplasm.
3. Congenital ependymomas – occurs in newborns, and their development begins at the stage of fetal life, in the mother’s womb. The causes of congenital tumors are unknown, only a higher incidence of lesions was observed in girls than in boys. A congenital tumor is usually located in the front of the alveolar process or the front of the hard palate. It can be up to several cm in diameter.
4.Pregnancy epiphyses – another name for this lesion is vascular epiplexus or pyogenic granuloma. There are many changes in the body of pregnant women that are designed to adapt their body to the course of pregnancy. Raging hormonal balance, combined with improper oral hygiene or trauma, contributes to the formation of pregnancy tumors (in about 5% of pregnant women). Vascular epilates usually appear in the first trimester of pregnancy and resolve spontaneously in the third trimester or after childbirth. The lesions have the shape of an intense red growth which usually does not cause any pain. The tumors are usually located on the interdental papillae, sometimes on the gingival margin (much less frequently). Sometimes the tumor may bleed due to minor trauma.
5. Fissured epilates – they are formed as a result of mechanical irritation of the oral mucosa or in people with incorrectly fitted dentures. In the beginning, the continuity of the mucosa is broken and the healing tissue is exposed to constant trauma. The result is an overgrowth of fibrous tissue which initially appears as a single fold that widens with continued use of a poorly fitted prosthesis. Then the fold becomes hard and surrounds the edges of the prosthesis. There are no pain complaints.
6. Hemangiomas – it’s about 30 percent all tumor localized in the mouth. We can see them more often in girls. Most lesions develop in the neck and head and are characterized by high metabolic activity of endothelial cells. Most hemangiomas appear and are diagnosed in the first weeks of a baby’s life. The first symptoms may go unnoticed: there are flat or faded plans that increase sharply, especially in the neonatal period. It is estimated that only 30 percent. tumors disappear by the end of the third year of life. In some cases, the process of involution lasts up to the age of 3.
7. Fibromas – are hard pink bumps with a smooth surface. Fibromas are usually located on the cheek mucosa and on the border of the hard and soft palate. Less frequently, lesions are observed on the tongue and lips. The most common cause of the formation of fibromas is mechanical irritation and taking certain drugs against epilepsy.
Diagnosis of gum tumors
In the diagnosis of gingival tumors, the location of the lesion is important, if it is symmetrical on both sides – there is no cause for concern. Black color of the lesion may mean melanoma, and purple sarcoma or hemangioma. Abscesses are very sensitive to pressure. In order to determine whether the gum tumor is related to the condition of the adjacent teeth, their viability and the periodontium condition should be determined.
How To Treat Gum Lumps?
Treatment of gum tumors primarily involves their surgical removal along with the margin of healthy tissue. The operation is usually performed under local anesthesia, and after the procedure, the removed tissues are sent for histopathological examination. In the case of a giant cell tumor, the bone in the area of the bone lesion is removed. Tumors in pregnant women usually resolve spontaneously in the third trimester of pregnancy, so in this case there is no need for surgery. The exception is when tumors cause malocclusion and make life and swallowing difficult. Then the operation is performed even during pregnancy (the best period is the second trimester of pregnancy).
Gum Tumors – What’s the prognosis?
Prompt diagnosis and appropriate treatment give a good prognosis. However, it should be remembered that gum tumors like to reoccur, especially when the original lesion is not completely removed. Each resected lesion should be sent for histopathological examination in order to exclude the transformation of the tumor into a neoplasm. There can be many lesions of a similar appearance in the human mouth. Therefore, it is very important to differentiate gum tumors from other ailments, e.g .:
- fibromas,
- gum cancer,
- a peripheral variant of an intraosseous giant cell lesion.
Good oral hygiene is very important in preventing the disease!
Lit .: [1] Diseases of the lips and oral mucosa. [In:] Braun-Falco O., Plewig G., Wolff HH, Burgdorf WHC: Dermatology, eds. half. Gliński W., Wolska H., Wydawnictwo Czelej, Lublin 2004, 1106.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House
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