Pyogenic Granuloma

chronic Inflammatory hyperplasia.

1. Pyogenic granuloma Dr Amitha

2. Common Inflammatory hyperplasia. Non-neoplastic, painless. The name is a misnomer since: no pus , not granuloma. Tumor like. Nodular growth in the oral cavity. Introduction

3. 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

4. Early lesions : Bleed easily Extreme vascularity. Mature lesions: The vascularity decreases More collagenous Pink. Clinical feature

5. Later lesions : Fibrous maturation Resemble and/or Become fibromas. Can have a rapid growth pattern Clinical feature

6. Clinically identical to, Peripheral ossifying fibroma and peripheral giant cell granuloma. These two lesions: only on the gingiva or alveolar mucosa Pyogenic granuloma : anywhere Same : clinical appearance, treatment, and prognosis Clinical feature

7. 75% on the gingiva, Most frequently: buccal gingiva _interproximal tissue. In the maxillary gingiva (especially anterior region) More than the mandibular gingiva; Location:

8. Effects the facial gingiva more than the lingual gingiva. Some lesions affect both the facial and lingual gingivae. Location:

9. Also in : the lips, tongue (especially the dorsal surface), and buccal mucosa. 9 Location:

10. 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

11. International Lesions have a similar frequency throughout the world. Race No racial predilection is reported. Age any age, most frequently affect young adults . Epidemiology

12. 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. Gender

13. Radiography findings are negative . If calcifications are present, Then the lesion probably is a peripheral ossifying fibroma , Imaging Studies

14. This lesion is a reactive/inflammatory process. Ulcerated mucosa Para-keratotic or non-keratinized sse Core: lobulated , cellular Histology

15. Fibrous connective tissue Proliferation of vascular channels. Few collagen. Inflammatory infiltrate ( by plasma cells, lymphocytes and neutrophils) Histology

16. Capillary hemangioma

17. Hemangioma

18. Peripheral giant cell granuloma

19. Peripheral ossifying fibroma

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