Pyogenic granuloma
Study guide
Classification of lesion: benign reactive connective tissue hyperplasia, tumor like, an inflammatory lesion.
Clinical description: red-purple, exophytic, ulcerated lesion which is soft and bleeds easily. Develops rapidly, may be sessile or pedunculated, different sizes.
Radiographic description: no radiographic findings in pyogenic granuloma.
Common locations: most common: gingiva. Also other areas: lips, tongue, buccal mucosa, and hard palate.
Etiology (cause):
1. Response to an injury (trauma) or irritation (ex/calculus)
2. Puberty.
3. Pregnancy.
Prognosis: excellent prognosis, there is no recurrence if it is removed adequately. The gingival cases and lesions removed during pregnancy have a high recurrence
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Many factors play a significant role in the development of pyogenic granuloma like traumatic injury, chronic oral irritation (ex. calculus, and overhanging restorations), hormonal changes, and pregnancy (Svirsky, &James, 2016).
Proper removal of pyogenic granuloma will minimize recurrence rate, and reveal a good prognosis. Removal of pregnancy tumors has a high recurrence rate (Svirsky, &James, 2016).
Excisional surgery is the treatment of choice for pyogenic granuloma, followed by curettage of underlying tissue. The lesion removed with two mm of the peripheral margins, deeply penetrated to the periosteum or to the irritant factors like calculus or overhanging restorations to remove them properly (Kamal, Dahiya, & Puri, 2012).
Generally, pyogenic granuloma occurs between 4.5 - 93 years, but females in 20s and 50s most commonly affected than males. Pregnant woman is at a high risk of developing pyogenic granuloma in the term of “pregnancy tumor” (Kamal, Dahiya, & Puri, 2012). In addition, patients with poor oral hygiene, and hormonal changes will show a high incidence of pyogenic granuloma (Ibsen, & Phelan, sixth edition,
Skin and mucous membrane integrity of head and neck, evidence by gingival bleeding and inflammation due to inadequate self-oral care. (Generalized moderate chronic periodontitis).
Recurrence rate was 1.9% (12 patients), in which all patient were retreated conservatively and had complete healing, none required surgical intervention.
Shortness of breath and sudden chest pain are the primary symptoms. The chest pain is typically localized to the affected side. Tiredness may also be a symptom.
One of the most common things that can occur during pregnancy is gingivitis. With the increased levels of progesterone, it can
The extensiveness of treatment for an ABC depends on the location, severity, and progression of the disease. Although the treatment spectrum ranges from minimally invasive to more invasive procedures, the standard of therapy is to resect the lesion and prevent it from returning in the future (Dhanasekaraprabu et al., 2013). However, complete resection is not always possible. For instance, it is difficult to completely remove lesion tissue from the proximal region of the metaphysis, and incomplete removal of the tissue leaves the patient susceptible to the development of another lesion at the site (Dormans et al., 2004). Cysts located at the proximal region of the femur are especially at an increased risk of recurrence (Mankin et al. 2005).
Males represented 54% of the affected patients, and certain tumors showed a strong male predilection, like MEC (6/10), PLGA (2/2), Adenoid cystic carcinoma (ACC) (5/8), Adenolymphoma (1/1); in contrast, some tumors such as PA (7/10), Acinic cell carcinoma (4/6) showed a female predilection. The mean age for malignant tumors in females (40.6 years) was lower than
Modified mastectomy include removal of the entire breast (nipple, areola, the overlying skin, and the lining over the chest muscles), and most of the lymph nodes under the arm (axillary lymph nodes) Often, breast cancer spreads to these lymph nodes, thereby entering the lymphatic system and allowing the cancer to spread to other parts of the body. Removal of lymph nodes may affect the drainage of lymphatic fluid from the arm on the surgical side. Problems with lymphatic drainage may
It¡¯s estimate that thirty percent of people with periodontal disease were genetically susceptible. Exposure may also play a role in contracting the disease. People have contracted it from their partners. Pregnancy plays a role as well because when women are pregnant their bodies are generally more susceptible. A pregnant woman¡¯s gums are also extremely sensitive. Other common contributing factors are stress, types of medications a person has taken (oral contraceptives and anti-depressants), diabetes, poor nutrition and bruxism (clenching and grinding your teeth). These factors can be changed or properly maintained in order to stop contributing to the periodontal disease. It is also important to note that these factors cannot be blamed for the main cause of this disease.
After surgical intervention, recurrence of gingival fibromatosis is considered unpredictable.16, 17 Oral hygiene is considered to be of paramount importance on the prognosis of gingival fibromatosis, as poor oral hygiene can aggravate the gingival enlargement. Mild recurrence was reported apparent in one study 20 months post-surgery due to poor plaque control10, while another study reported that there was no recurrence in 14 years in patients with good oral
Bright red or dark red spots in the back area on the roof of the mouth near the throat.
However other researchers may argue that periodontal disease can increase a mother’s rate of having preeclampsia (Paquette, 2006). In the study of “Periodontal disease and the risk for adverse pregnancy outcome” researchers look at the adverse effect of preeclampsia and the risk factors (Paquette, 2006). As studies have shown that inflammatory occurrences in paternal and fetal membranes happen in the course of normal deliveries but they seem higher for premature delivers and any other complication for pregnancy (Paquette, 2006). As there has been many observational studies that been done over the last decade (Paquette, 2006). There has been a persistent and substantial association with paternal exposure to periodontal disease that affect the
As stated by the Center for Disease Control and Prevention, “Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed and over 8,000 deaths due to oral cancer occur.” (CDC). Most adults are unaware that they have periodontal disease or gum disease, this occurs because they do not maintain routine checkups with their dentist. When we insert food and other bacteria into our mouths, it affects our teeth and gums. We need routine dental checkups and cleanings throughout our lives. Dental checkups usually involve x-rays, cleanings, and the examination of the mouth.
2. Symptoms are a firm, red nodule that may bleed sometimes. A flat lesion with a scaly crust on your face, ears, neck, hands or arms
Though specific subject selection criteria are not mentioned in the article, subject selection bias is not observed as cases reported in this article include both sexes, age range reported is broad from 31 to 70 years old the location and clinical appearance of each oral lesion were different. Author has reported and discussed each case and analyzed similarities and differences in all case reports. As per my opinion this study has following issues:
Recurrence rates could be lower with aggressive surgery, recurrences often continue. After radical excision, the disease has been reported to recur in 33% of patients15. In our study, the recurrence rate was 12.5% (122 patients) in the conservative method group, which is within an acceptable range. While in the surgical method group, the recurrence rate was zero (0%) which can be attributed to the mild to moderate severity of the disease in that group, in addition to the proper postoperative care, change of personal hygiene, and compliance in avoiding