The evaluation of fibrous epulis excisional biopsy

A fibrous epulis is a typical tumor-like lesion occurring on the gingiva, which usually appears on the interdental papilla as a result of local irritation. This case report presents a large fibrous epulis reoccurring for the second time six months after an excisional biopsy via electrosurgery. This case report aimed to evaluate the reoccurrence and management of a fibrous epulis and to describe the associated risk factors. A 26-year-old male presented to the Dental Teaching Hospital at the Faculty of Dentistry, Universitas Indonesia, with the complaint of a large, painless, non-hemorrhagic mass on his gums. The mass was previously excised at another hospital in January 2016. A reoccurring mass was observed on the lower right, measuring 2.5 cm × 1.4 cm × 1.2 cm buccally (pedunculated) and 3.1 cm × 1.3 cm × 1.3 cm lingually (sessile), covering the occlusal area of the posterior teeth. The pocket depth, loss of attachment, and tooth mobility grade were also measured. Bone involvement was noted in the radiographic findings. In January 2017, the mass was removed for biopsy purposes. An electrosurgical excision was performed without any flap surgery and accompanied by periodic control. Six months after the excision, the mass reoccurred for the second time. The fibrous epulis recurrence rate is unknown but linked to various factors. In this case, the epulis had grown back six months after the excision; therefore, fibrous epulis cases need to be followed up periodically.