inflammation. Pseudoepitheliomatous appearance can be seen In advanced cases, this hyperplasia is pseudoepitheliomatous in appearance. A chronic inflammatory cell infiltrate containing lymphocytes and plasma cells is usually seen, Rarely, polymorphonuclear leukocytes are also present. Proliferation of fibrovascular tissue occurs in nodules with a variable lymphoplasmacytic infiltrate. Differential diagnosis Inflamed squamous papilloma: usually solitary and pedunculated. Human papillomavirus–associated papillary lesions or condylomas: they contain koilocytes Treatment For early lesions of inflammatory papillary hyperplasia, cessation of denture use for 2 to 4 weeks may allow the lesion to completely subside. This may be aided by use of topical antibiotic or antifungal therapies. Small lesions are also typically treated with mouthrinses such as chlorhexidine mouthrinse at 0.12% or antifungal mouthrinse/ gels. For more advanced and large lesions, excision of the hyperplastic tissue may be required before fabricating a new denture. Several surgical methods have been used, including: Partial-thickness or full-thickness surgical blade excision Electrosurgery Curettage Laser surgery Cryosurgery Lesions removed by electrosurgery require an average of 30 to 33 days to heal, whereas lesions removed by surgical curettage require around 21 to 23 healing days. During healing interval, the existing denture can be lined with a temporary tissue conditioner that acts as a palatal dressing and provides greater comfort. Surgical removal of the lesion and the making of new dentures are effective in eradication of the lesion. Good oral hygiene practice is very important in preventing repetition of events leading to the condition again. Proper denture hygiene care should be carried out as instructed by your dentist and nocturnal use of dentures should be eliminated. Epidemiology Due to the strong association with denture-wearing, the lesion tends to occur more in adults than children. There is no gender predilection. In people who wear dentures 24 hours a day, its incidence is around 20%. Inflammatory papillary hyperplasia almost exclusively involves the hard palate, specifically the vault of the palate. Extension of the lesion to the mucosa of the residual ridges have also been observed. 11% to 13.9% of patients who wear maxillary complete dentures with complete palatal coverage has been reported to have IPH. References External links Oral mucosal pathology