J Adv Prosthodont.  2014 Dec;6(6):555-558. 10.4047/jap.2014.6.6.555.

Focal epithelial hyperplasia arising after delivery of metal-ceramic fixed dental prosthesis

• Park MW
• Cho YA
• Kim SM
• Myoung H
• Lee JH
• Lee SK

• KMID: 2284731
• DOI: http://doi.org/10.4047/jap.2014.6.6.555

Abstract

Focal epithelial hyperplasia (FEH) is a human papillomavirus (HPV)-induced alteration of the oral mucosa that presents with a clinically distinct appearance. While other HPV-infected lesions such as squamous papilloma, verruca vulgaris, and condyloma acuminatum involve the skin, oral mucosa, and genital mucosa, FEH occurs only in the oral mucosa. The affected oral mucosa exhibits multiple papules and nodules with each papule/nodule being flat-topped or sessile. The affected region resembles the normal color of oral mucosa rather than appearing as a white color since the epithelial surface is not hyperkeratinized. Almost all cases present with multiple sites of occurrence. This rare, benign epithelial proliferation is related to low-risk HPV, especially HPV-13 and -32, and is not transformed into carcinoma. We report a case of FEH that arose on the attached gingiva of an East Asian male adult related to prosthesis without detection of any HPV subtype in HPV DNA chip and sequencing.

Keyword

Focal epithelial hyperplasia (FEH); Human papillomavirus (HPV); Attached gingiva; HPV DNA chip; Porcelain-fused to metal (PFM)

MeSH Terms

Adult
Asian Continental Ancestry Group
Dental Prosthesis*
Focal Epithelial Hyperplasia*
Gingiva
Humans
Male
Mouth Mucosa
Mucous Membrane
Oligonucleotide Array Sequence Analysis
Papilloma
Prostheses and Implants
Skin
Warts

Figure

• 

  Fig. 1 Clinical intraoral view of the elevated nodules in the right upper posterior buccal gingiva (A) and in the left lower lingual attached gingiva (B) with a panoramic radiograph (C). A papillary proliferating pattern with acanthosis. Rete ridges were widened and elongated, but were not psoriasiform (original magnification, ×12.5) (D). Stratum spinosum layer showing a few mitosoid cells among the normal keratinocyte without brisk mitotic figures (original magnification, ×400) (E, F).

• 

  Fig. 2 Immunohistochemical results of Ki-67 and p53. Ki-67 was immunoreactive in the cells of the suprabasal layer as well as the basal cell layer, indicating hyperplasia of the keratinocytes (A), and p53-positive cells were scattered within the epithelium, but were few in number (B) (original magnification, ×400). Mitosoid cells were positive for Ki-67, but negative for p53. All the negative results of the DNA chip analysis (C, D).

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