Oral Pyogenic Granuloma Clinical Presentation

Updated: Mar 29, 2018
  • Author: John A Svirsky, DDS, MEd; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Presentation

History

Early lesions bleed easily due to extreme vascularity. Pyogenic granulomas can have a rapid growth pattern that can cause alarm. If left alone, a number of pyogenic granulomas undergo fibrous maturation and resemble and/or become fibromas.

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Physical Examination

The typical lesion involves the interproximal gingiva and increases in size to cover a portion of the adjacent teeth. The maxillary gingiva (especially in the anterior region) is involved more frequently than the mandibular gingiva; the facial gingiva is involved more than the lingual gingiva. A number of lesions affect both the facial and lingual gingivae.

Pyogenic granulomas usually present as smooth or lobulated red-to-purple masses that may be either pedunculated or sessile. As lesions mature, the vascularity decreases and the clinical appearance is more collagenous and pink. Pyogenic granulomas vary in size from a few millimeters to several centimeters and are painless. These tumors are soft to palpation.

Note the images below.

Pyogenic granuloma of the anterior maxilla showing Pyogenic granuloma of the anterior maxilla showing a small amount of involvement on the buccal gingiva of teeth numbers 8 and 9 with most of the lesion on the lingua. Note that indentations from the lower teeth are on the surface of the tumor.
Pyogenic granuloma of the dorsal tongue in a 52-ye Pyogenic granuloma of the dorsal tongue in a 52-year-old black woman. An area of geographic tongue is adjacent to the pyogenic granuloma.
Pyogenic granuloma associated with teeth numbers 2 Pyogenic granuloma associated with teeth numbers 20 and 21 in a 27-year-old white woman who is 8 months pregnant. The lesion was excised without curetting the area to remove irritants.
Same patient as in Image 4 with a lesion that recu Same patient as in Image 4 with a lesion that recurred almost immediately. This picture was taken 1 month after the birth of her child.
Rapidly growing pyogenic granuloma in the area of Rapidly growing pyogenic granuloma in the area of teeth numbers 20 and 21 in a 13-year-old black girl. Notice the calculus and plaque on tooth number 22. The lesion was soft to palpation.
Pyogenic granuloma on the facial gingiva of teeth Pyogenic granuloma on the facial gingiva of teeth numbers 7 and 8. This is a long-standing lesion that is becoming fibrosed and less vascular. Notice the pink coloration at the base of the lesion.
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