Pyogenic granuloma of the oral cavity. Case presentation and review of the literature

Pyogenic granuloma (GP) or oral pyogenic granuloma (OPG) is a benign vascular neoplasm that is significantly associated with oral trauma and irritation, such as biofilm and calculus. It occurs most commonly in women and has a predilection for the oral mucosa, particularly the gingiva and interdental papillae.
It presents as a papular or tumorous lesion, often with a pedunculated shape, with a colour varying between red and wine, soft to palpation and haemorrhagic, often ulcerating at the surface and able to grow to a large size.
Its characteristics resemble other oral lesions such as peripheral odontogenic fibroma, hemangioma, inflammatory gingival hyperplasia, peripheral giant cell granuloma, non-Hodgkin's lymphoma, etc.
Surgical treatment is preferred, but it should be preceded by periodontal treatment to avoid recurrence, which occurs frequently. The histopathological examination shows an abundance of granulation tissue, a significant amount of vascularity and inflammatory cells.
A case is presented in which a lesion is observed in the oral cavity, specifically in the marginal gingiva, with a presumptive diagnosis of pyogenic granuloma, with the aim of removing the lesion from the area due to the discomfort and risk of plaque accumulation and potential impact on the patient's dental health.
Clinical case
A 20 year old patient arrived for consultation at the diagnostic area of the School of Dentistry of the Pedro Henríquez Ureña National University (UNPHU), presenting slightly red gum with plaque accumulation, dental crowding in the anterior inferior area, bulging in the lower area between teeth #22 #23 and #24 in the vestibular region.
In the anamnesis the patient had no symptoms, he referred an increase in size of 4 months, rounded and soft tumor lesion on palpation with a pedunculated base of implantation, covering all the attached marginal gingiva in the area of incisors #22 #23 and #24.
She was referred to oral pathology for further evaluation. A record was filled out, an X-ray of the affected area was taken, in which no bone loss was observed in the area, and planning for surgical removal of the lesion, after obtaining two presumptive diagnoses: calcifying fibroblastic granuloma and pyogenic granuloma.
Prior to surgery, the patient was admitted to the periodontics area of the School of Dentistry of the Pedro Henríquez Ureña National University (UNPHU) where the clinical history was filled out with a diagnosis of biofilm-induced gingivitis with reduced periodontium. Hygiene instructions were given and the treatment plan included initial prophylaxis and intermediate prophylaxis, followed by re-evaluation and subsequent surgical excision. He was prescribed analgesic and antibiotic medication and chlorhexidine rinses. Histopathological results corroborated the diagnosis of Pyogenic Granuloma.

化脓性肉芽肿（GP）或口腔化脓性肉芽肿（OPG）是一种与口腔创伤和刺激（如生物膜和牙石）显著相关的良性血管性新生物。该病最常见于女性，并倾向于发生于口腔黏膜，尤其是牙龈和牙间乳头。其表现为乳头状或肿瘤性病变，常呈有蒂状，颜色介于红色和葡萄酒色之间，触之柔软且易出血，表面常出现溃疡，并有可能生长至较大尺寸。其特征与多种口腔病变相似，如周围牙源性纤维瘤、血管瘤、炎症性牙龈增生、周围巨细胞肉芽肿、非霍奇金淋巴瘤等。手术切除是首选治疗方法，但应先进行牙周治疗以避免复发，复发率较高。组织病理学检查显示丰富的肉芽组织、显著的血管化和炎症细胞。本文介绍了一例口腔内观察到病变的病例，具体位于边缘牙龈，初步诊断为化脓性肉芽肿，由于病变引起的不适、牙菌斑积累的风险以及对患者口腔健康潜在的负面影响，旨在从该区域移除病变。
临床病例
一位20岁的患者在佩德罗·恩里克兹·乌雷尼亚国立大学（UNPHU）牙科学院的诊断区域进行咨询，表现为轻微发红的牙龈和牙菌斑积累，前下区域牙齿拥挤，第22、23和24号牙之间的下颌区域突出。在病史中，患者没有症状，他提到4个月来病变体积增大，触摸时发现为圆形、柔软的肿瘤性病变，有蒂状基底部，覆盖了22、23和24号前牙区域的全部附着牙龈。她被转介至口腔病理科进行进一步评估。填写了病历记录，拍摄了受影响区域的X光片，显示该区域没有观察到骨丧失，并计划在获得两个初步诊断：钙化纤维性肉芽肿和化脓性肉芽肿后进行病变切除手术。手术前，患者被收入佩德罗·恩里克兹·乌雷尼亚国立大学（UNPHU）牙科学院的牙周病学区域，填写了临床病史，诊断为由生物膜引起的牙龈炎伴牙周组织减少。给予了卫生指导，治疗计划包括初步预防和中期预防，随后进行再评估和后续手术切除。他被处方了止痛药和抗生素药物以及氯己定漱口水。组织病理学结果证实了化脓性肉芽肿的诊断。