Cyst Buccal Swelling — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOral SurgeryCyst Buccal SwellingORE Part 1

A patient has a smooth, firm, dome-shaped swelling on the labial gingiva of the alveolar ridge, below the mucogingival junction. The overlying mucosa is normal in colour and the lesion is non-tender. It has been present for several months. The adjacent teeth are vital, there is no history of extraction at the site, and radiography shows no bony lesion. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Fibrous epulis

The correct answer is C, fibrous epulis. A fibrous epulis is a chronic reactive gingival overgrowth that typically presents as a painless, firm, mucosa-coloured mass. Here, the lesion is clinically soft-tissue in origin: it is firm but not bony, has normal mucosal covering, and radiography shows no osseous lesion. Vital adjacent teeth make a radicular cyst unlikely, as this is normally associated with pulpal necrosis. A residual cyst requires a previous extraction at the affected site. A lateral periodontal cyst is an intraosseous lesion and would be identified radiographically. Buccal exostosis is a hard bony prominence rather than a discrete soft-tissue swelling. Definitive diagnosis of an excised epulis requires histopathological examination.

Reference: Agrawal AA. Gingival enlargements: Differential diagnosis and review of literature. World Journal of Clinical Cases. 2015. Figure 1 describes fibrous epulis/peripheral fibroma as a pink, firm, uninflamed gingival mass. https://pubmed.ncbi.nlm.nih.gov/30049170/