Soft tissue lesions

A list of a few of the less common dental soft tissue lesions

Dental soft tissue lesions that I think are interesting.

Epulis granulomatosa

Epulis granulomatosa is found in poorly healing post extraction sites. The lesion just needs excision.

Picture of an epulis granulomatosa after a tooth extraction.

Epulis fissuratum

Epulis fissuratum is excess tissue grow from a poorly fitting denture.

Epulis fissuratum

Mucous Membrane Pemphigoid (MMP)

MMP is one of several auto-immune conditions that are both difficult to accurately diagnosis and difficult to effectively treat. Treatments are simply managing the symptoms. Differentials include erythema multiforme, Stevens Johnson syndrome, and other autoimmune blistering diseases such as pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, and linear IgA bullous dermatosis.

Photo of a case of Mucous Membrane Pemphigoid or MMPHerpetic Gingivostomatitis

The differential between erythema multiforme with ANUG and herpetic gingivostomatitis with ANUG is tricky. If you see vesicles or honey crusted lips then think herpetic. Punched out papilla is a sign of ANUG. This is a tricky case and diagnosis.

Case of herpetic gingivostomatitis with ANUG

Erythema multiforme

Again hard to tell if erythema multiforme or herpetic gingivostomatitis. This one came up after a new medication. Erythema multiforme is a mild version of Stevens-Johnson syndrome.

Erythema multiforme lesions on the lip

Peripheral ossifying fibroma vs Peripheral Odontogenic Fibroma

Not sure the difference can be made without a biopsy. The case report here is very similar clinically to the lesion below. This could also be a peripheral giant cell granuloma but the color isn’t consistent with that.

Determining if this a peripheral ossifying fibroma or Peripheral Odontogenic Fibroma without a biopsy is impossible.

Peripheral ossifying fibroma vs Peripheral Odontogenic Fibroma?

Oral chronic graft-versus-host disease

There are many soft tissue issues with this disease. The disease happens to bone marrow transplant patients.

 

Unknown soft tissue lesions

This one is most likely an ischemic event brought on from the injection, trauma from surgery, or the healing process. It is possible that is is a chemical burn but seems unlikely with the clear delineation of the lesion along the mucogingival junction. This cologne burn does look similar and appears to stay on the keratinized tissue.

Photo of an ischemic keratinized gingiva.

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