Application Of Ultrasound Doppler-Guided Ligation In Treating Vascularized Epulis

Although surgical extirpation is typically the standard method for epulis, this procedure often involves invasive procedures with massive bleeding and anesthesia risk. This concern is particularly pertinent when treating patients who may not tolerate surgery such as pregnancy, lactation or with other systemic diseases. Moreover, in areas with limited medical resources, the conditions for performing surgical excision are restricted, resulting in patients being unable to receive timely treatment. The treatment of epulis has evolved significantly, with a shift toward minimally invasive, patient-specific and low-cost approaches. In these scenarios, we utilized Doppler-guided epulis ligation (DGEL) as a minimally invasive alternative to effectively treat vascularized gingival pyogenic granuloma. This approach was successfully applied to a diverse group of patients, including a pregnant patient, a lactating patient, a Sturge-Weber syndrome patient, and a nasopharyngeal carcinoma patient. Blocking the arterial supply is the key success of DGEL. Combined the advance of Doppler ultrasonography, clinicians can precisely targets the vascular supply of the lesion. Using Doppler ultrasound, clinicians can make a preliminary diagnosis of vascular epulis by comparing the vascularization with healthy side. After ligating the feeding arteries, clinicians can use Doppler ultrasound to determine a complete blood block. DGEL is an easy-to-perform technique that has been well-accepted by patients and has yielded favorable outcomes for large vascularized epulis treatment.