Transcript granulation tissue

PYOGENIC
GRANULOMA
a relatively common reactive, tumorlike growth of oral cavity
nonneoplastic
In spite of its name
Unrelated to infection
No true granuloma
an exuberant tissue response to local irritation or trauma
Clinical Features
a smooth or lobulated mass
usually pedunculated,
although some lesions are sessile
The surface is characteristically ulcerated
color
size
ranges from pink to red to purple, depending on the age of the lesion
only a few millimeters in
to several centimeters in diameter
Typically painless
often bleeds easily
may exhibit rapid growth
gingiva (75%) > lips, tongue, buccal mucosa
maxillary gingiva > mandibular gingiva
anterior areas > posterior areas
facial > lingual
some extend between the teeth
at any age
most common in children and young adults
a definite female predilection,
pregnancy tumor
may begin to develop during the first trimester
their incidence increases up through the seventh month of pregnancy
A large lesion arising from the palatal gingiva in association with an orthodontic
band.
The patient was pregnant.
Hemorrhagic,ulceratedgingival mass pregnant woman
Epulis granulomatosa
hyperplastic growths of granulation tissue that sometimes arise in healing
extraction sockets
a granulation tissue reaction to bony sequestra in the socket
Nodular mass of granulation tissue that developed in a recent extraction site
Histopathologic Features
a highly vascular proliferation that resembles granulation tissue
In healing wounds
fibrin clot
fibrous connective tissue
granulation tissue
Numerous small and larger endothelium-lined channels
Neutrophils ………………………….near the ulcerated surface
chronic inflammatory cells ………..deeper in the specimen
capillary blood vessels and scattered inflammation.
channels are formed that are engorged with red blood cells
The surface is usually ulcerated and replaced by a thick fibrinopurulent membrane
Older lesions may have areas with a more fibrous appearance.
In fact, many gingival fibromas probably represent pyogenic granulomas
that have undergone fibrous maturation.
Treatment and Prognosis
conservative surgical excision
Diff.Diagnosis:
PGCG
The specimen should be submitted for microscopic examination
Peripheral
fibroma
to rule out other
more seriousodontogenic
diagnoses.
peripheral ossifying fibroma
rarely metastatic cancer
For gingival lesions, the excision should extend down to periosteum
the adjacent teeth should be thoroughly scaled to remove any source
of continuing irritation
Occasionally, the lesion recurs
For pregnanc tumors…. …….usually treatment should be deferred
unless significant functional or aesthetic problems develop
The recurrence rate is higher for pyogenic granulomas removed during
pregnancy
some lesions will resolve spontaneously after parturition
The End