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

20. Thankyou
And
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Dr Amitha