Kayla Garcia

Brittany Ryder
Kelsey Watson
Case Study Report
Our case study involves a 68-year-old edentulous male that visited a dental office for
evaluation of numerous bumps under his upper denture. The choices in the case study to choose
from were nicotine stomatitis, inflammatory papillary hyperplasia, inflammatory fibrous
hyperplasia, denture sore mouth, or verrucous leukoplakia. After concluding research, we believe
the clinical diagnosis of this patient is inflammatory papillary hyperplasia. Papillary hyperplasia
is a form of denture-induced hyperplasia, it is almost always associated with a maxillary
removable full or partial denture or orthodontic appliance. The clinical appearance of
inflammatory papillary hyperplasia involves the palatal mucosa, most commonly in the vault
area, and is covered by erythematous papillary projections that give the area a granular
appearance. It is usually related to an ill-fitting denture or other removable prosthetic device. The
history the patient commented on, that his upper denture had been reconstructed four years
earlier and no longer fit well would be an exact comparison to inflammatory papillary
hyperplasia. The intraoral examination also revealed clues that pointed towards inflammatory
hyperplasia. For example, the soft-tissue papillary growths in the palatal vault area and the
mucosal surface of the papillary areas appeared reddish in color is also a signs of inflammatory
papillary hyperplasia.
Nicotine stomatitis would not be an answer because of several different reasons. Nicotine
stomatitis is a benign lesion on the hard palate associated with heavy, long-term pipe and cigar
smoking and is due to the effect of heat on the palatal mucosa; it is also associated with cigarette

smoking. Although the clinical appearance of inflammatory papillary hyperplasia and nicotine
stomatitis is similar; the medical history did not reveal that the patient uses nicotine.
Inflammatory fibrous hyperplasia is also not the correct answer due to several different
clinical appearances. ** IM ASSUMING THIS IS DENTURE-INDUCED FIBROUS
HYPERPLASIA** Denture-induced fibrous hyperplasia is a lesion caused from an ill-fitting
denture and is generally located in the vestibule along the denture flange and is arranged in
elongated folds. Our patient does have an ill-fitting denture, but there is no clinical appearance of
elongated folds of tissue into which the denture flange fits. In denture-induced fibrous
hyperplasia, the surface of the lesion is often ulcerated. There was no ulcerations revealed during
the intraoral exam, this states that inflammatory fibrous hyperplasia cannot be a correct
diagnosis.
Another option for the clinical diagnosis was denture sore mouth. This is not the correct
option because the patient described the bumps under his upper denture as painless.
The last choice to choose from was verrucous leukoplakia; this option was also not
correct. Verrucous leukoplakia is clinically seen as white patches that are mostly commonly
located on the mucous membranes of the oral cavity including the tongue. Additional places
verrucous leukoplakia is found on include: floor of the mouth, alveolar mucosa and gingiva. This
would not be a correct diagnosis because verrucous leukoplakia is a patch which is not a raised
surface. The color appearance of the verrucous leukoplakia is white and our patient presented
with red raised bumps.

References
IBSEN, O. A., & Phelan, J. A. (2014). Oral Pathology for the Dental Hygienist (6th ed.). St.
Louis, MI: Elsevier.
Mete, O. M., Keskin, Y., Hafiz, G., Kayhan, K. B., & Unur, M. (2010). Dermatology Online
Journal. Retrieved September 19, 2016, from https://escholarship.org/uc/item/2tp4f7kx