Surgical Management of Bilateral Denture-Induced Inflammatory Fibrous Hyperplasia Using Scalpel Excision with Adjunctive 940-nm Diode Laser: A Case Report

Rationale: Denture-induced inflammatory fibrous hyperplasia (IFH), clinically referred to as epulis fissuratum, is a reactive soft tissue lesion caused by chronic mechanical irritation from ill-fitting or overextended dental prostheses. Bilateral presentation is uncommon and reflects prolonged, symmetrical trauma. Surgical excision with elimination of the etiological factor remains the treatment of choice. Patient Concerns: A 55-year-old female denture wearer presented with progressively enlarging, painless soft tissue overgrowths in the maxillary anterior vestibular region for three months, associated with discomfort during mastication and speech. Diagnosis: Clinical examination revealed bilateral, sessile, firm fibrous masses in the maxillary labial vestibule corresponding to the denture flange. Based on clinical findings, a provisional diagnosis of denture-induced inflammatory fibrous hyperplasia was made and later confirmed by histopathological evaluation. Interventions: The lesions were surgically excised under local anesthesia using a scalpel for precise removal and preservation of tissue architecture. A 940-nm diode laser was used adjunctively to achieve hemostasis. Histopathological analysis demonstrated parakeratinised stratified squamous epithelium overlying a fibrocellular connective tissue stroma with chronic inflammatory infiltrate. The ill-fitting denture was discontinued, and prosthetic rehabilitation was planned following healing. Outcomes: Postoperative healing was uneventful, with satisfactory soft tissue resolution and no evidence of recurrence during the follow-up period. Lessons: This case highlights the importance of early diagnosis and correction of prosthetic etiological factors in dentureinduced reactive lesions. A combined scalpel and diode laser approach offers precise excision, superior hemostasis, and favorable healing outcomes, particularly in extensive bilateral IFH