Pathology · patient case question
What is the tissue lesion at the denture border?
Patient case: Case: something under the denture
Scenario: A denture wearer reports feeling something beneath the prosthesis and is worried it may be malignant. On examination the palate is diffusely red beneath the denture, and there is a folded, fibrous overgrowth of tissue at the denture border. Four linked questions followed.
Show answer and explanation
Correct answer: B. Epulis fissuratum
- A. Carcinoma would be indurated and ulcerated with rolled borders, and would not conform so neatly to the flange outline. The patient's fear is reasonable but the clinical picture is reassuring.
- B. Correct. Epulis fissuratum is a reactive hyperplasia of fibrous connective tissue produced by a chronically overextended or ill-fitting denture flange. The classic sign is folds of tissue with the flange sitting in the fissure between them.
- C. A peripheral giant cell granuloma is a purple-red gingival mass arising from the periodontal ligament or periosteum, typically in dentate areas, and can resorb underlying bone.
- D. A fibroma is a discrete, smooth, dome-shaped nodule from focal trauma — not a folded overgrowth along a denture border.