New treatment strategy for granulomatous epulis: intralesional injection of propranolol.

Epulis is a relapsable lesion in gingiva without specific treatment for its unexplained pathogenesis. Nowadays, surgical excision is the most popular method of treatment. To prevent recurrence, it is necessary to resect diseased tissues thoroughly, and even to remove the involved teeth. However, this may cause functional and cosmetic deformities. Therefore, it is urgent to find a new therapy without severe side effects. Infantile hemangioma is a common benign pediatric tumor which shares many features with epulis, such as rich vascularity, high incidence of female patients, high hormone level and similar treatments. A recent study showed that propranolol, a beta adrenergic receptor (β-AR) antagonist, was effective as treatment for infantile hemangioma. Our preliminary work showed that mRNA and protein levels of β2-AR were higher in epulis than in adjacent tissue. Therefore, we hypothesize that intralesional injection of propranolol may be useful as epulis treatment. Further work need to be done to confirm the safety and therapeutic effect of the treatment. After that, this specific β2-AR antagonist may be the first choice for epulis treatment.