Inflammatory Fibrous Hyperplasia – Inflammatory papillomatosis
- The hard palate and maxillary gingiva are by far the most common sites but papillomatosis may occasionally be seen in other areas
- In almost all cases, it is associated with an ill-fitting denture.
- The palatal vault is commonly involved and it has a granular, multinodular appearance that is erythematous.
Histologically, the multinodular surface is covered by a usually intact parakeratinized epithelium. The nodules or papillary projections consist of fibrous tissue with varying degrees of chronic inflammation. The surface crypts may sometimes harbor candidal organisms, which may also have a stimulatory action on this lesion.
The clinical management of this common condition is usually nonsurgical. The denture must be rebased or relined and the infection treated with anticandidal drugs. Nystatin oral suspension 100,000 U/mL, a white tasteless solution, 5 mL (1 tsp), is used four times daily as a swish and swallow and also placed under the denture. In addition or as an alternative, nystatin powder 100,000 U/g may be placed under the denture. Persistent cases may require the addition of a systemic anticandidal agent such as fluconazole (Diflucan, Pfizer), 100 mg daily, taken orally.