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A parulis or fistula granuloma (gum boil), is a common lesion that develops exclusively on the gingiva (gum).

It is characteristically found at the opening of the sinus tract of a peri-apical or periodontal fistula. Infection from the tooth / socket has tracted through the bone and opens onto the gingiva. It can vary in size (dependent on the amount of pus being produced and the state of the person’s immune system).

Clinically, the lesion presents as a painless, exophytic granulation tissue mass is identical to pyogenic granuloma.,

Removal of the source of infection (that is, root canal treatment of the tooth or tooth extraction) normal resolves the parulis though it is not uncommon for parulides to become autonomous if there is still a focus of infection ‘feeding it’.

Also, parulides can develop on the skin whereby the infection has totally bypassed the gingiva and tracts out on to the skin. This is often in the area of the chin and the infection is associated with non-vital (i.e dead) lower incisors.

The OMFS department gets involved as the dermatologists have tried to treat the parulis but have failed. I have seen quite substantial parulides associated with lower molars as well.

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New Zealand Dermatology