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.