Gingival Overgrowth in an Adult Male Patient

Abstract

Pyogenic granuloma (PG) is an oral reactive inflammatory hyperplasia of connective tissue that can occur in response to hormonal changes and local irritation such as calculus, fractured teeth, rough dental restorations, and foreign materials. It is nonneoplastic and predominant in the second decade of life in young adult females. The most common site of involvement is the gingiva. Lesions are more common in the maxillary than mandibular gingiva and mainly occur on the facial or buccal aspect. Pyogenic granuloma rarely grows more than 2 cm in diameter and is rarely associated with bone loss. This article presents a rare case of an abnormally large pyogenic granuloma affecting both the labial and palatal gingiva sustaining occlusal trauma due to its size and associated with severe alveolar bone loss that was managed successfully with surgical excision in a 40-year-old male.

Keywords: bone loss; exophytic nodule; gingival overgrowth; pyogenic granuloma; reactive benign lesion.

Figure 1. The growth extending from the distal aspect of the lateral incisor to the mesial aspect of the canine

Figure 2. The palatal lesion is observed to be coral pink in color with multiple intermixed red and white areas across the extent of the surface

Figure 3. Intraoral periapical radiograph of the upper left lateral incisor and the canine region

Figure 4. Histopathological finding showing focally ulcerated stratified squamous epithelium covering a core of loose and edematous fibrous connective tissue

Figure 5. Histopathological finding showing the stroma containing numerous endothelial-lined blood-filled capillaries and a dense infiltrate of lymphocytes, plasma cells and neutrophils