Inflammatory Papiilary Hyperplasia of the Palate
Inflammatory papillary hyperplastic tissue formation in the palate is frequently a result of mechanical irritation and is seen most often in patients who wear prosthetic appliances. Other potential contributing factors to thispsocess include poor hygiene, fungal infections, and the associated nflamrr.ation. This condition usually appears as multiple nodula projections in the palatal tissue. Although it was onve thought to represent a recancerous condition, this 1′, ‘S not been substantiated.l” Because theprocess appears to be primarily inflammatory rather than neoplastic, total full-thickness incision is not necessary. In fact, in the very early stages, onsurgical treatment,such as proper denture adjustment combined with a tissue conditioner, may eliminate or reduce this problem. If rem oval is required, a mucosal excision superficial to the periosteum is recommended and can generally be performed with local anesthetic infiltration in the palatal area. Regardless of the technique used for removal of this tissue, a specimen should be obtained and submitted for histopathologic examination. Guernsey’!! described a technique using electrosurgical loops for excision of the 0palatal mucosa. When electrosurgical techniques are
used, it is important to maintain a split-thickness excision so that palatal bone is not cauterized. An alternative technique that elimmates this possibility is split-thickness. excision done sharply with a scalpel.V However, palatal form and access to the area of excision may limit
the use of this scalpel technique in certain situations. Techniques to abrade the superficial layer of palatal mucosa are also effective for treatment. A coarsely fluted acrylic or bone bur or dermabrasion brush in a rotating
handpiece can be used for this purpose (Fig. 13-24). Other techniques that can be considered for superficial tissue removal include cryosurgery and the use of lasers. After tissue incision, insertion of a splint or denture containing soft tissue liner provides impro ‘cd patient comfort during
the healing period. Secondary epithelialization usually takes place in approximately 4 weeks.