Denture-Induced Hyperplasia — ORE Part 1 MCQ

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EasyOral PathologyDenture-Induced HyperplasiaORE Part 1

A 72-year-old edentulous woman presents with a painless, firm, pedunculated lesion on the lower alveolar ridge. It is covered by normal mucosa and has been present for several years. Her lower complete denture is ill fitting. What is the most likely diagnosis?

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Correct answer: D — Denture-induced fibrous hyperplasia

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E

A is correct. Denture-induced fibrous hyperplasia is a benign reactive fibrous overgrowth caused by chronic trauma from an ill-fitting or overextended denture. It may present as a firm, sessile or pedunculated lesion in the denture-bearing sulcus or alveolar mucosa. The long duration, normal surface mucosa and absence of pain or bleeding support this diagnosis. Pyogenic granuloma is usually soft, red and vascular, with a tendency to bleed. Peripheral giant cell granuloma is more often red-blue or purple and arises from gingiva or alveolar mucosa, without the characteristic denture-trauma history. Squamous cell carcinoma and verrucous carcinoma require consideration for persistent suspicious lesions, but ulceration, induration, surface change or progressive destructive behaviour would be more concerning than the benign chronic presentation described.

Reference: Er-Raji S, Rokhssi H, Ennibi O. Diode laser surgery for the treatment of denture-induced fibrous hyperplasia: a case report. Pan African Medical Journal. 2024. https://pubmed.ncbi.nlm.nih.gov/38766568/