Oral pyogenic granuloma

05/03/2023 09:27:30 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة

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Oral Pyogenic GranulomaSupervised By:Dr-Ahmed TalebBDS M.Sc Peridontology

Dr-Muthanna Ibraheem

BDS

Dr-Moamen Mowafaq

BDS

Done By


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Common Inflammatory

hyperplasia. Non-neoplastic. painless.

The name is a misnomer since

• no pus • not granuloma.

Introduction Tumorlike. Nodular growth in

the oral cavity.


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Surface: • usually ulcerated Color:• red-to-purple. smooth or lobulated pedunculated or sessile. soft to palpation.

Size: • vary in from a few millimeters to several centimeters

Clinical feature


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Early lesions : bleed easily extreme vascularity. Mature lesions: the vascularity decreases more collagenous pink.

Clinical feature


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Later lesions : fibrous maturation resemble and/or become fibromas.

can have a rapid growth pattern that can cause alarm.

Clinical feature


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clinically identical to, peripheral ossifying fibroma and peripheral giant cell granuloma.

These two lesions: only on the gingiva or alveolar mucosa PG : anywhere . Same : clinical appearance, treatment, and prognosis

Clinical feature


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75% on the gingiva, Most frequently: buccal

gingiva _interproximal tissue.

In The maxillary gingiva (especially anterior region)

more than the mandibular gingiva;

Location:


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The facial gingiva more than the lingual gingiva. Some lesions affect

both the facial and lingual gingivae.

Location:


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Also in : the lips, tongue (especially the dorsal surface), and buccal mucosa.

Location:


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extragingival : A history of trauma gingiva : irritation.

Most in Individuals with chronic oral irritants (eg, overhanging

restorations, calculus) poor oral hygiene and Hormonal change Implantitis, around an implant.

Causes


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International Lesions have a similar frequency throughout

the world.

Race No racial predilection is reported.

Age any age, most frequently affect young

adults.

Epidemiology


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Females more susceptible than males.

because of the hormonal changes

during puberty, pregnancy, and menopause.

Also called a "pregnancy tumor“ occur in 1% of pregnant women.

Sex


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Radiography findings are negative.

If calcifications are present, then the lesion probably is a peripheral ossifying fibroma,

Imaging Studies


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This lesion is a reactive/inflammatory process.

ulcerated mucosa parakeratotic or non-

keratinized SSE.Core: lobulated cellular

Histology


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fibrous connective tissue

proliferation of vascular channels.

Few collagen. inflammatory

infiltrate ( by plasma cells, lymphocytes and neutrophils)

Histology


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conservative surgical excision to the periosteum

scaling adjacent teeth to remove any calculus and plaque.

Management


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Alternative protocols:

Nd:YAG Laser Cryosyrgery Intralesional injection of ethanol or

corticosteroid. Sclerotherapy.

Management


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In pregnant women: When possible, wait after delivery to

remove the lesion. because of a greater tendency for

recurrence during pregnancy. In a number of cases, mastication on the

lesion causes bleeding and pain and requires surgical intervention before parturition.

Some lesions regress after childbirth without surgical intervention.

Management


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Prevention: routine dental cleanings and home care,

especially during pregnancy.

Complications: No complications ,only chance of a cosmetic

gingival defect.

Management


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Prognosis: excellent, usually does not recur unless inadequately

removed. The recurrence rate is higher during pregnancy.

Patient Education: Focus on better oral hygiene.

Management


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Thank You

Health & Medicine

Oral pyogenic granuloma