The Surgical Management of Large Denture-Induced Fibrous Hyperplasia of The Upper Labial Mucose: A Case Report

Abstract

Background: Denture-induced fibrous hyperplasia often occurs because of mechanical irritation from ill-fitting denture on the oral mucosa. Although it is asymptomatic, it may affect the mastication and aesthetic of the patient negatively due to discomfort. Chronic trauma by the borders of ill-fitting dentures has the potential to cause oral carcinoma. Hence, denture-induced fibrous hyperplasia should not be overlooked. The treatment of this oral lesion can be surgical removal with scalpels.

Case Report: A 62-year-old woman presented with a painless mass on the upper labial mucosa. The patient reported that the lesion had gradually enlarged over time. The patient had no history of systemic disease. Clinical examination revealed a well-defined nodular mass measuring approximately 3.5 × 2 × 1.5 cm located on the upper lip mucosa. The lesion appeared pinkish in color with a smooth surface and firm consistency on palpation. The patient reported prolonged use of a removable denture that had become unstable, which frequently caused irritation to the right maxillary lip mucosa. Based on the clinical findings, a provisional diagnosis of fibromatous epulis (inflammatory fibrous hyperplasia) was considered.

Management and Outcome: Complete surgical excision was performed under general anaesthesia, considering the large size of the lesion, the need for optimal surgical access, and perioperative considerations in a geriatric patient. The lesion was removed using an elliptical incision followed by careful dissection and wound closure with a combination of interrupted and continuous sutures. Histopathological examination confirmed the diagnosis of denture-induced fibrous hyperplasia. Postoperative healing was uneventful, and the patient reported significant improvement in comfort and lip contour.

Conclusion: Surgical excision is an effective treatment for large denture-induced fibrous hyperplasia. Careful surgical planning and appropriate perioperative management in geriatric patients are essential to achieve favorable clinical outcomes and prevent recurrence.

Keywords: Denture-induced fibrous hyperplasia, Epulis fissuratum, Oral surgery, Geriatric patient