INFLAMMATORY
PAPILLARY HYPERPLASIA
&
RANULA

Presented By :Irfan Zunzani
III rd Year
INFLAMMATORY PAPILLARY
HYPERPLASIA /PALATAL OR
DENTURE PAPILLOMATOSIS
Introduction
• Papillary hyperplasia is a unusual condition
involving the mucosa of the palate.
• It is of unknown etiolog...
ETIOLOGY
• Exact pathogenesis is not known.
• An ill-fitting denture.

• Poor denture hygiene.
• Wearing the denture 24 ho...
CLINICAL FEATURES
• SITE –
 Hard

palate beneath a denture

base.
 Edentulous mandibular alveolar
ridge.
• The lesion presents itself as
numerous, closely arranged, red, edematous
papillary projections.
• The individual papilla...
HISTOLOGICAL FEATURES
• Microscopic section shows numerous, small vertical
projections each composed of parakeratotic or
s...
Treatment
• Discontinuing the use of ill fitting denture or
construction of new denture without surgical
removal of the ex...
RANULA
Frog belly
Definition
• Name derived from Latin word rana, which
means frog, because the swelling may
resemble a frog’s translucent u...
CLINICAL FEATURES
• Appears as blue, dome-shaped, fluctuant
swelling in the floor of mouth.
• Deeper ranulas are normal in...
• An unusual clinical variant.
• The PLUNGING or
CERVICAL RANULA.
• Occurs due to herniation of
spilled mucin through the
...
Differential diagnosis
•
•
•
•
•

Dermoid cyst,
Abscess,
Hemangioma,
Lymphangioma,
Lymphoepithelial cyst.
HISTOPATHOLOGIC
FEATURES
• Variable epithelial lining of cuboidal,
columnar, or atrophic squamous cells,
surrounding the t...
EPITHELIAL LINING SHOWS CUBOIDAL TO COLUMNAR EPITHELIUM
WITH SCATTERED MUCIN – PRODUCING CELLS
TREATMENT AND
PROGNOSIS
• Removal of the feeding sublingual gland
& marsupialization (i.e. to unroof the
lesion rather tha...
Inflammatory pappilary hyperplasia & ranula
Inflammatory pappilary hyperplasia & ranula
Inflammatory pappilary hyperplasia & ranula
Inflammatory pappilary hyperplasia & ranula
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Inflammatory pappilary hyperplasia & ranula

  1. 1. INFLAMMATORY PAPILLARY HYPERPLASIA & RANULA Presented By :Irfan Zunzani III rd Year
  2. 2. INFLAMMATORY PAPILLARY HYPERPLASIA /PALATAL OR DENTURE PAPILLOMATOSIS
  3. 3. Introduction • Papillary hyperplasia is a unusual condition involving the mucosa of the palate. • It is of unknown etiology. • It may be considered a from of inflammatory hyperplasia associated in instances with ill fitting denture.
  4. 4. ETIOLOGY • Exact pathogenesis is not known. • An ill-fitting denture. • Poor denture hygiene. • Wearing the denture 24 hours a day. (20% OF PATIENTS). • Candida also has been suggested as a cause.
  5. 5. CLINICAL FEATURES • SITE –  Hard palate beneath a denture base.  Edentulous mandibular alveolar ridge.
  6. 6. • The lesion presents itself as numerous, closely arranged, red, edematous papillary projections. • The individual papillae are seldom over a millimeter or two in diameter. • The tissue exhibit varying degrees of infllamation, but sometimes there is ulceration.
  7. 7. HISTOLOGICAL FEATURES • Microscopic section shows numerous, small vertical projections each composed of parakeratotic or sometimes orthokeratotic stratified squamous epithelium and a central core of connective tissue. • Pseudoepitheliomatous hyperplasia, in varying degrees, is seen in most of the cases. • Severe inflammatory cell infiltration is nearly always present in the connective tissue. • Chronic inflammatory cell consist of lymphocytes and plasma cells.
  8. 8. Treatment • Discontinuing the use of ill fitting denture or construction of new denture without surgical removal of the excess tissue will generally result in regression of edema and inflammation, but papillary hyperplasia persists. • Surgical excision of the lesion prior to new denture construction will return the mouth to a normal state. • Use of conditioner to rebase an old denture often results in some improvement of the lesion .
  9. 9. RANULA Frog belly
  10. 10. Definition • Name derived from Latin word rana, which means frog, because the swelling may resemble a frog’s translucent underbelly. • It is a form of mucocele that specifically occurs in the floor of the mouth in association with ducts of the submaxillary or sublingual gland. • It may arise through duct blockage or through development of ductal aneurysm.
  11. 11. CLINICAL FEATURES • Appears as blue, dome-shaped, fluctuant swelling in the floor of mouth. • Deeper ranulas are normal in color. • Lesion develops as a slowly enlarging painless mass located lateral to the midline of the floor of the mouth. • Ranulas can develop into large masses that are many centimeters in diameter, fill the floor of mouth and elevate the tongue.
  12. 12. • An unusual clinical variant. • The PLUNGING or CERVICAL RANULA. • Occurs due to herniation of spilled mucin through the mylohyoid muscle, producing swelling within the neck.
  13. 13. Differential diagnosis • • • • • Dermoid cyst, Abscess, Hemangioma, Lymphangioma, Lymphoepithelial cyst.
  14. 14. HISTOPATHOLOGIC FEATURES • Variable epithelial lining of cuboidal, columnar, or atrophic squamous cells, surrounding the thin or mucoid secretions in the lumen. • Some cysts (more commonly those arising due to ductal obstruction) demonstrate oncocytic metaplasia of the epithelium.
  15. 15. EPITHELIAL LINING SHOWS CUBOIDAL TO COLUMNAR EPITHELIUM WITH SCATTERED MUCIN – PRODUCING CELLS
  16. 16. TREATMENT AND PROGNOSIS • Removal of the feeding sublingual gland & marsupialization (i.e. to unroof the lesion rather than to excise it totally). • Occasionally the lesion recur if the entire sublingual gland or other gland causing them is not excised with the lesion
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