Patients who have dentures should be advised to seek routine dental care in the form of soft tissue examinations and oral cancer screenings. In addition: dentures do not fit an individual for the rest of his or her life; the alveolar bone remodels over time, and the denture teeth wear down from use so they need to be evaluated routinely for fit and function. Eventually, all dentures must be relined or replaced. Wearing the denture too often also plays a part in the development of denture-induced fibrous hyperplasia. Dentures should always be left out of the mouth for period of time every day. One of the problems associated with denture-induced fibrous hyperplasia is the tendency for these areas to develop fungal infections(candidiasis) that require treating the denture along with the soft tissue. Patients should be shown how to care for their dentures and for the soft tissues that support them. Refer to Clinical Protocol 11 for information about how to care for a denture
Differential Diagnosis: The traumatic fibroma is clinically similar to many of the other soft tissue enlargements. A definitive diagnosis depends on histologic findings after biopsy. Some of the most likely lesions in the differential diagnosis include the following:
1. Neurofibroma, Chapter 17 Chapter 17
2. Neurilemoma,
3. Lipoma, Chapter 17
4. Peripheral ossifying fibroma. Chapter 17
The surface of denture-induced fibrous hyperplasia may be rough or papillary, in which case it can resemble vrrucous carcinoma(see Chapter 16) or verruca vulgaris(see Chapter 16)
Treatment and Prognosis: Surgical removal of the fibroma is the treatment of choice. However, recurrence is likely if the source of the trauma is not removed. Surgical removal is also indicated for denture-induced fibrous hyperplasia. In addition, a new, better-fitting denture should be constructed, and the patient should be advised concerning correct methods of denture care. The prognosis for both forms of this lesion is excellent if the source of the irritation is removed. If the source is not eliminated, there is a good risk of recurrence.