Oral Pyogenic Granuloma Clinical Presentation
- Author: John A Svirsky, DDS, MEd; Chief Editor: William D James, MD more...
Early lesions bleed easily due to extreme vascularity. Pyogenic granulomas can have a rapid growth pattern that can cause alarm. If left alone, a number of pyogenic granulomas undergo fibrous maturation and resemble and/or become fibromas.
The typical lesion involves the interproximal gingiva and increases in size to cover a portion of the adjacent teeth. The maxillary gingiva (especially in the anterior region) is involved more frequently than the mandibular gingiva; the facial gingiva is involved more than the lingual gingiva. A number of lesions affect both the facial and lingual gingivae.
Pyogenic granulomas usually present as smooth or lobulated red-to-purple masses that may be either pedunculated or sessile. As lesions mature, the vascularity decreases and the clinical appearance is more collagenous and pink. Pyogenic granulomas vary in size from a few millimeters to several centimeters and are painless. These tumors are soft to palpation.
Note the images below.
A history of trauma is common in extragingival sites, whereas most lesions of the gingiva are a response to irritation. Individuals with poor oral hygiene and chronic oral irritants (eg, overhanging restorations, calculus) most frequently are affected.
In 2010, a case of pyogenic granuloma was reported around an implant. This will be a more common occurrence as the number of implants and associated peri-implantitis continues to increase.
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