Workup
Imaging Studies
Obtain a periapical radiograph of the associated teeth in lesions that involve the teeth. Radiography findings are negative if the lesion is a pyogenic granuloma. If calcifications are present, then the lesion probably is a peripheral ossifying fibroma, which is clinically identical to the pyogenic granuloma and requires the same treatment of removal with scaling of the adjacent teeth.
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Histologic Findings
Histologic examination reveals sectioned soft tissue consisting of a lesion composed of ulcerated mucosa covering a core of cellular fibrous connective tissue admixed with proliferating vascular channels and a mixed inflammatory infiltrate. This lesion is a reactive/inflammatory process.
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Media Gallery
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Typical appearance of a pyogenic granuloma involving the buccal gingiva of teeth numbers 20 and 21. Note the extreme vascularity.
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Pyogenic granuloma of the anterior maxilla showing a small amount of involvement on the buccal gingiva of teeth numbers 8 and 9 with most of the lesion on the lingua. Note that indentations from the lower teeth are on the surface of the tumor.
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Pyogenic granuloma of the dorsal tongue in a 52-year-old black woman. An area of geographic tongue is adjacent to the pyogenic granuloma.
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Pyogenic granuloma associated with teeth numbers 20 and 21 in a 27-year-old white woman who is 8 months pregnant. The lesion was excised without curetting the area to remove irritants.
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Same patient as in Image 4 with a lesion that recurred almost immediately. This picture was taken 1 month after the birth of her child.
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Rapidly growing pyogenic granuloma in the area of teeth numbers 20 and 21 in a 13-year-old black girl. Notice the calculus and plaque on tooth number 22. The lesion was soft to palpation.
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Pyogenic granuloma on the facial gingiva of teeth numbers 7 and 8. This is a long-standing lesion that is becoming fibrosed and less vascular. Notice the pink coloration at the base of the lesion.
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