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Manlove AE, Quintana EN, Cuellar LM, Linnebur AM. Benign Intraoral Soft Tissue Lesions in Children. Oral Maxillofac Surg Clin North Am 2024; 36:265-282. [PMID: 38395668 DOI: 10.1016/j.coms.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Benign intraoral soft tissue pathology in pediatric patients includes developmental, traumatic, inflammatory, and infectious lesions. Common pathology includes gingival cysts, mucoceles, fibromas, and parulis. Less common lesions include peripheral ossifying fibromas, congenital epulis of the newborn, and congenital mandibular duct atresia. Most of these lesions present at painless masses but can have significant effects on children and their caregivers. Although these lesions are generally harmless, evaluation and treatment is necessary for appropriate management and health of the child.
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Affiliation(s)
- Ashley E Manlove
- Carle Illinois College of Medicine, Carle Cleft and Craniofacial Team, Carle Foundation Hospital, Urbana, IL, USA.
| | - Erik N Quintana
- Division of Oral and Maxillofacial Surgery, Carle Foundation Hospital, Urbana, IL, USA
| | - Leticia M Cuellar
- Division of Oral and Maxillofacial Surgery, Carle Foundation Hospital, Urbana, IL, USA
| | - Alexis M Linnebur
- Arnold Palmer Hospital for Children - Orlando Health, 207 W. Gore Street, 3Road Floor, Suite.302, Orlando, FL 32806, USA
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2
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Hamilton MFA, Hiscox LA. Clinical Characterisation of Caudal Traumatic Malocclusions and Treatment Outcomes in Cats (2018-2022). J Vet Dent 2024; 41:114-121. [PMID: 37312535 DOI: 10.1177/08987564231181055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Caudal malocclusions in cats may result in a variety of traumatic lesions affecting the soft tissues of the ipsilateral mandible such as fovea, gingival cleft, and proliferative lesions. Fifty-one cats diagnosed with a traumatic caudal malocclusion were compared with a control hospital population and evaluated for prevalence with respect to breed and sex. Twenty-two cats that were treated had radiographic, clinical findings, and the outcome of treatment (extraction or odontoplasty) recorded. Maine Coon, Persian, and male neutered cats were overrepresented while Domestic Shorthairs were underrepresented within the study population. Radiographically, 50% of the fovea lesions had an area of decreased bone density in the region of the lesion and none of these had evidence of periodontal disease. All gingival cleft lesions had radiographic changes consistent with periodontal disease. 15.4% of proliferative lesions presented with radiographic changes, with only half of those presenting with both radiographic and clinical evidence of periodontal disease. Eleven cats were treated by odontoplasty and eleven by extraction. One cat treated by odontoplasty developed new lesions caudally, and another had persistence of the initial lesions. Two cats in the extraction group developed new lesions rostral to the extracted teeth. In most instances, odontoplasty or extraction resulted in successful soft tissue lesion resolution. In rare cases, additional treatment was necessary due to either persistence or development of new lesions.
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Affiliation(s)
- Martin F A Hamilton
- Dentistry and Oral Surgery, Ottawa Animal Emergency and Specialty Hospital, Ottawa, Canada
| | - Lorraine A Hiscox
- Dentistry and Oral Surgery, Ottawa Animal Emergency and Specialty Hospital, Ottawa, Canada
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3
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Basiari L, Komnos I, Litsou E, Michali M, Oikonomou P, Psychogios G. Pyogenic Granuloma Gravidarum of the Nasal Cavity Causing Recurrent Epistaxis. A Case Report and Review of the Literature. MAEDICA 2024; 19:160-164. [PMID: 38736920 PMCID: PMC11079736 DOI: 10.26574/maedica.2024.19.11.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Pyogenic granuloma is a benign proliferative fibrovascular lesion commonly arising from the skin and mucous membranes of the head and neck region. Histologically, this tumor is characterized by vascular proliferation and a circumscribed group of capillaries organized in lobules. It is usually located in the oral cavity and nasal location is less frequent. When it occurs in pregnant women, it is usually referred as pyogenic granuloma gravidarum. In this article we present the case of a pyogenic granuloma gravidarum in a young woman with intermittent epistaxis during the last trimester of pregnancy that did not resolve after childbirth and was treated with transnasal endoscopic resection and cautery at the base of the lesion for hemostasis under local anesthesia.
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Affiliation(s)
- Lentiona Basiari
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Ioannis Komnos
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Eleni Litsou
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Maria Michali
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Panagiotis Oikonomou
- Consultant Pathologist, Department of Pathology, University Hospital of Ioannina & General Hospital of Ioannina "G. HATZIKOSTA", Ioannina, Greece
| | - Georgios Psychogios
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
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Silva PG, Paula DS, Soares GC, Cavalcante LN, Nascimento IV, Sousa FB, Mota MR, Alves AP. Role of collagen and immunostaining for TGF-β in the clinical and microscopic findings of pyogenic granuloma and peripheral ossifying fibroma. Med Oral Patol Oral Cir Bucal 2024; 29:e288-e296. [PMID: 38288849 PMCID: PMC10945864 DOI: 10.4317/medoral.26268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/08/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Collagen is a component of Pyogenic Granuloma (PG) and Peripheral Ossifying Fibroma (POF) and performs different functions in these lesions. The objective of this study is to evaluate the role of collagen and immunostaining for Transforming Growth Factor beta (TGF-β) in the clinical and microscopic findings of PG and POF. MATERIAL AND METHODS PG (n=20) and POF (n=20) were selected for clinical evaluation (sex, age, localization, size and evolution time) and microscopic analysis (picrosirius red staining for collagen analysis and immunohistochemistry for TGF-β) performed in the superficial and deep areas of the two lesions. ANOVA/Bonferroni and t-test, Pearson correlation and χ2 were used to compare the sites and parameters analyzed (p<0.05, GraphPad Prism 5.0). RESULTS The depth of PG presented the highest amount of collagen (p<0.001), and its surface showed the lowest amount of type 1 collagen (yellow-red strong birefringence). Type 1 collagen gradually increased in depth of PG, surface and depth of POF (p<0.001). The number of TGF-β+ cells was lower on the surface of PG compared with the depth of PG and the two areas of POF (p<0.001). Sex and localization did not affect these parameters, but the profile of collagen and immunostaining for TGF-β suffered from modifications by the time of evolution and the size of the lesion. CONCLUSIONS Although PG and POF are reactive gingival lesions, the expression of TGF-β and its role in collagen showed different biological behaviors in these lesions, suggesting different biological origins for its components.
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Affiliation(s)
- P-G Silva
- Division of Oral Pathology, Dental School Federal University of Ceará Alexandre Barauna Street, 949, Rodolfo Teofilo 60430-160, Fortaleza, Ceará, Brazil
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5
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Phull T, Dadhwal H, Kaur R, Malhotra R, Jyoti D, Kaur R. Oral Pyogenic Granuloma at Different Spots: A Series of Case Reports. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S999-S1001. [PMID: 38595587 PMCID: PMC11001051 DOI: 10.4103/jpbs.jpbs_703_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 04/11/2024] Open
Abstract
Pyogenic granuloma is an inflammatory non-neoplastic lesion of the oral cavity. Chronic, mild, local irritation, trauma, hormonal variables, and certain medications are typical causes of pyogenic granulomas. Women have a higher prevalence than men. The risk is greatest in the second to fifth decades of life. Clinically, the lesion appears smooth, with soft to firm consistency and nontender with a pedunculated or sessile base. Various modalities have been proposed for the treatment of lesion, which include the conventional approach, the use of laser, cryotherapy, and electrocauterization. This case series discusses three cases of pyogenic granuloma in female patients at different locations in the oral cavity. The lesion was subsequently treated with electrosurgery and surgical convention methods. No recurrence of the lesion has been seen in either of the cases.
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Affiliation(s)
- Tanvi Phull
- Department of Oral and Maxilofacial Surgery, Gian Sagar Dental College, Patiala, Punjab, India
| | - Hima Dadhwal
- Department of Periodontology, Government Dental College and Hospital, Patiala, Punjab, India
| | - Rajpreet Kaur
- Department of Periodontology, Government Dental College and Hospital, Patiala, Punjab, India
| | - Ritu Malhotra
- Department of Prosthodontics, ITS Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Divya Jyoti
- Department of Oral Health Sciences (Periodontics), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ravneet Kaur
- Department of Periodontology, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
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Shirani AM, Tadayonnezhad P, Arzani S, Kiansadr SO, Kaviani N. Laser Excisional Biopsy of Bleeding Tumor near Newly Erupted Tooth in an 11-Month-Old Patient under General Anesthesia. Case Rep Dent 2024; 2024:6668716. [PMID: 38274320 PMCID: PMC10810691 DOI: 10.1155/2024/6668716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/20/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Pyogenic granuloma (PG) is a well-known tumor-like growth that commonly appears in the gingiva of the oral cavity. This reactive lesion can develop in response to local irritation, chronic low-grade trauma, long-term low-grade infection, or hormonal imbalances. PG is more frequently observed in individuals during their second and third decades of life, although it can occur at any age. It is more prevalent in young females than males, but on rare occasions, it can be found in children, even infants. Several treatment options exist for PG lesions, which apply after a final diagnosis specified by biopsy and histopathological investigations. Surgical excision is the most common treatment choice for PG lesions. However, comparisons between laser therapy and surgical excision have shown numerous advantages for laser treatment, making it a preferred option for soft tissue lesions. Laser excision offers benefits such as precise and deep incisions, preservation of sterile conditions, improved hemostasis, avoidance of sutures, and less invasive procedures resulting in reduced intra- and postoperative discomfort, pain, and bleeding. This report is aimed at presenting a case of an 11-month-old infant with a gradually growing pyogenic granuloma (PG) lesion that appeared in the palate behind the upper left first deciduous tooth, with a duration of approximately 2 months. The parents reported a history of bleeding associated with the lesion, which emerged after the eruption of the mandibular tooth. An excisional biopsy was done by the application of an 810 nm diode laser under general anesthesia, and the specimen was evaluated by a pathologist. No posttreatment complications or relapses were observed in this case.
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Affiliation(s)
- Amir Mansour Shirani
- Oral Medicine Department, Dental School, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
- Fellowship of Laser Therapy in Dentistry, RWTH Aachen University, Aachen, Germany
| | | | - Sarah Arzani
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Nasser Kaviani
- Oral and Maxillofacial Department, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Baskurt D, Vural S, Ertekin SS, Baykal C. Oral mucosa involvement in pediatric patients with xeroderma pigmentosum: a comprehensive review. Int J Dermatol 2024; 63:59-72. [PMID: 37964400 DOI: 10.1111/ijd.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder presenting with an inability to repair UV-induced DNA damage. This can lead to the development of neoplasms affecting multiple organ systems, with onset often in childhood. Unfortunately, no cure currently exists for XP, and management strategies focus on sun protection and early intervention for malignancies. Although most skin problems in XP patients are UV induced, various oral lesions are also described. However, the literature has not extensively characterized the oral manifestations and their prognostic significance. METHODS We conducted a comprehensive review to evaluate the prevalence and nature of oral mucosal lesions in pediatric XP patients. RESULTS Our literature search yielded 130 pediatric XP patients with oral involvement and 210 associated tumoral or non-tumoral lesions. Squamous cell carcinoma was the most common type of oral mucosal tumor reported, with other malignancies including basal cell carcinoma, melanoma, angiosarcoma, fibrosarcoma, and trichilemmal carcinoma. CONCLUSION Given the potential morbidity and mortality associated with oral mucosal tumors in XP patients, our study aims to raise awareness of these manifestations. Early diagnosis and treatment are crucial for managing these lesions effectively, and routine oral exams should be considered a critical component of dermatological evaluations for XP patients, especially in the pediatric age group.
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Affiliation(s)
- Defne Baskurt
- School of Medicine, Koç University, Istanbul, Turkey
| | - Secil Vural
- School of Medicine, Koç University, Istanbul, Turkey
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Sümeyre S Ertekin
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Lalremtluangi R, Dangore-Khasbage S. Reactionary Bone Changes in Long-Standing Pyogenic Granuloma: A Case Report. Cureus 2024; 16:e53021. [PMID: 38410319 PMCID: PMC10895205 DOI: 10.7759/cureus.53021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Pyogenic granuloma is a reactive lesion that is commonly seen in the skin and oral cavity. Though it is an unfortunate misnomer, being neither pyogenic nor a true granuloma, the name has been used for years. In the oral cavity, it presents as a growth mostly situated on the gingiva, but may also occur on the tongue, buccal and labial mucosa, and palate, and may even be seen in relation to dental implants. The lesion is usually bright or purple red in color, soft in consistency, relatively painless, and appears highly vascularized. Local etiologic factors are usually poor oral hygiene or chronic irritation. Histopathologically it is an inflammatory hyperplasia of the connective tissue with exuberant vascularity. Sometimes, this lesion may present with unusual histopathological patterns, which could lead to difficulty in diagnosis. Long-standing pyogenic granuloma may show histologic changes such as localized osteogenesis in the matrix of the lesion which could potentially lead to complications in the area of the lesion. This article reports a rare case with rare histopathological features in an 18-year-old female presenting with long-standing soft tissue gingival growth.
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Affiliation(s)
- Rosalyn Lalremtluangi
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suwarna Dangore-Khasbage
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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9
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Sonar PR, Panchbhai AS. Pyogenic Granuloma in the Mandibular Anterior Gingiva: A Case Study. Cureus 2024; 16:e52273. [PMID: 38357065 PMCID: PMC10864220 DOI: 10.7759/cureus.52273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/14/2024] [Indexed: 02/16/2024] Open
Abstract
The oral cavity is frequently affected by gingival pyogenic granuloma (PG), a benign tumor that is known for its quick growth and tendency to hemorrhage. The clinical presentation, diagnostic procedure, and treatment of a patient with gingival pyogenic granuloma are all detailed in this case study. A female individual aged 25 years in otherwise good condition arrived with a sessile gingival tumor in the anterior mandibular region that was expanding quickly. During dental hygiene procedures, there was intermittent bleeding and discomfort related to the lesion. Based on histology analysis and clinical examination, PG was diagnosed. The course of treatment included surgical excision followed by a histological analysis to ensure total eradication. Appointments for follow-up revealed adequate healing and no indications of recurrence. This case study aims to demonstrate the need for prompt diagnosis, appropriate treatment, and diligent follow-up to effectively manage gingival pyogenic granuloma. Dental professionals can better treat patients and achieve better results with a thorough understanding of this common oral lesion and its management.
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Affiliation(s)
- Prasanna R Sonar
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aarati S Panchbhai
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Raj SC, Mishra AK, Tabassum S, Baral D. Lobular capillary hemangioma with an intraosseous feeder vessel through an accessory buccal foramen in the mandible: A unique case report. J Indian Soc Periodontol 2024; 28:138-142. [PMID: 38988959 PMCID: PMC11232798 DOI: 10.4103/jisp.jisp_197_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 02/28/2024] [Accepted: 03/28/2024] [Indexed: 07/12/2024] Open
Abstract
The aim of this case report is to present a unique and rare finding in a 29-year-old male with the chief complaint of swelling in the gums related to the back teeth of the lower left jaw, since 20 days. In the absence of any alarming findings on the intraoral periapical radiograph and blood profile, an excisional biopsy of the provisionally diagnosed pyogenic granuloma was planned with a high-power diode LASER (Light Amplification by Stimulated Emission of Radiation). Following the excision, an unusual amount of bleeding was encountered from a single point on the buccal cortical plate between the teeth #35 and #36. On reevaluating the left face with advanced radiodiagnostic methods, an accessory buccal foramen was reported distal to #35 which housed a thin, tortuous, and aberrant branch of the inferior alveolar artery. The swelling was histopathologically diagnosed as lobular capillary hemangioma, and the aberrant artery was labeled as its feeder vessel. The patient had no episode of recurrence until 2 years of follow-up.
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Affiliation(s)
- Subash Chandra Raj
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Asit Kumar Mishra
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Shaheda Tabassum
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Debajani Baral
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
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Lomeli Martinez SM, Carrillo Contreras NG, Gómez Sandoval JR, Zepeda Nuño JS, Gomez Mireles JC, Varela Hernández JJ, Mercado-González AE, Bayardo González RA, Gutiérrez-Maldonado AF. Oral Pyogenic Granuloma: A Narrative Review. Int J Mol Sci 2023; 24:16885. [PMID: 38069207 PMCID: PMC10706684 DOI: 10.3390/ijms242316885] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic challenges due to its similarity and alarming proliferation. This narrative review synthesizes current knowledge on the epidemiology, etiopathogenesis, clinical manifestations, and management of oral PG, with emphasis on recent advances in diagnostic and therapeutic approaches. The epidemiology of the injury is meticulously analyzed, revealing a higher incidence in women and a wide range of ages of onset. It delves into the etiopathogenesis, highlighting the uncertainty surrounding the exact causal factors, although historical attributions suggest an infectious origin. It exhaustively analyzes the clinical and histopathological aspects of oral PG, offering information on its various presentations and the importance of an accurate diagnosis to guide effective treatment. It details treatment strategies, emphasizing the personalized approach based on individual patient characteristics. This comprehensive review consolidates current knowledge on oral PG, highlighting the need for further research to clarify its pathogenesis and optimize treatment protocols.
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Affiliation(s)
- Sarah Monserrat Lomeli Martinez
- Department of Medical and Life Sciences, University of Guadalajara (CUCiénega-UdeG), 1115 Ave. Universidad, Ocotlán 47810, Jalisco, Mexico; (S.M.L.M.); (J.J.V.H.)
- Master of Public Health, Department of Wellbeing and Sustainable Development, University of Guadalajara (CUNorte-UdeG), 23 Federal Highway, Km. 191, Colotlán 46200, Jalisco, Mexico
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico; (N.G.C.C.); (J.R.G.S.); (J.C.G.M.)
- Prostodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - Nadia Guadalupe Carrillo Contreras
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico; (N.G.C.C.); (J.R.G.S.); (J.C.G.M.)
| | - Juan Ramón Gómez Sandoval
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico; (N.G.C.C.); (J.R.G.S.); (J.C.G.M.)
- Research Institute of Dentistry, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - José Sergio Zepeda Nuño
- Microbiology and Pathology Department, Pathology Laboratory, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico;
| | - Juan Carlos Gomez Mireles
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico; (N.G.C.C.); (J.R.G.S.); (J.C.G.M.)
| | - Juan José Varela Hernández
- Department of Medical and Life Sciences, University of Guadalajara (CUCiénega-UdeG), 1115 Ave. Universidad, Ocotlán 47810, Jalisco, Mexico; (S.M.L.M.); (J.J.V.H.)
| | - Ana Esther Mercado-González
- Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, 777 Coronel Calderón, Guadalajara 44200, Jalisco, Mexico;
| | - Rubén Alberto Bayardo González
- Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico;
| | - Adrián Fernando Gutiérrez-Maldonado
- Department of Medical and Life Sciences, University of Guadalajara (CUCiénega-UdeG), 1115 Ave. Universidad, Ocotlán 47810, Jalisco, Mexico; (S.M.L.M.); (J.J.V.H.)
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12
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Meshram M, Durge K, Shirbhate U. An Overview of Oral Pyogenic Granuloma and Its Management: A Case Report. Cureus 2023; 15:e48305. [PMID: 38058325 PMCID: PMC10697180 DOI: 10.7759/cureus.48305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023] Open
Abstract
An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the buccal mucosa, tongue, and lips. Histologically, the surface epithelium may be hyperkeratotic, have ulceration foci, or be intact. It lies on the dense connective tissue that contains a sizable amount of fully developed collagen. Most of the pregnancies result in PG of the gingiva; for this reason, the phrases "Pregnancy Tumor" and "Granuloma Gravidarum" are frequently used. It typically occurs during the second and third months of pregnancy and tends to bleed, making it challenging to masticate. Estrogen increases the vascular endothelial growth factor (VEGF) synthesis in macrophages, which is associated with PG development during pregnancy. This case describes a surgically treated case of PG in a middle-aged female with a conventional scalpel technique, giving functional and esthetic outcomes in a patient.
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Affiliation(s)
- Mrunal Meshram
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Khushboo Durge
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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13
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Nwoga MC. Benign Orofacial Vascular Anomalies: Review of 47 Cases in Enugu, Nigeria. Niger J Clin Pract 2023; 26:1723-1727. [PMID: 38044779 DOI: 10.4103/njcp.njcp_332_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/01/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature. AIMS To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu. MATERIALS AND METHODS This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance. RESULT There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies. CONCLUSION Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.
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Affiliation(s)
- M C Nwoga
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
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14
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Dodal KA, Vishnani R, Reche A, Bhowate RR, K R. A Case Study on Pyogenic Granuloma With Review of the Literature: An Unexpected Sequela or a Complication of Dental Extraction? Cureus 2023; 15:e46592. [PMID: 37933368 PMCID: PMC10625792 DOI: 10.7759/cureus.46592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more prevalent in the third and fourth decades of life with a higher occurrence in females. Various factors contribute to its development and surgical removal is the gold standard treatment; however, there are various other methods available. This case report documents a rare event in which a female patient in her early 40s presented with an exophytic lesion affecting the extraction socket of her maxillary right lateral incisor. The lesion was effectively removed through surgical excision. Additionally, it explores the clinical features and pathogenesis of this lesion. The purpose of this case report is to shed light on the uncommon incidence of pyogenic granuloma following tooth extraction. This non-neoplastic vascular growth often presents as an erythematous, ulcerated lesion with a tendency to bleed, with either a sessile or pedunculated base. Our case is one of only five instances documented in the literature, underscoring the importance of knowledge and timely response in such unusual circumstances. We emphasize the significance of early detection and management for improved patient outcomes and a better understanding of this rare condition.
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Affiliation(s)
- Ketan A Dodal
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rozina Vishnani
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amit Reche
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul R Bhowate
- Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajanikanth K
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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15
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Al-Otaibi LM, Al-Ali MM. The Use of Diode Laser for the Surgical Removal of Pyogenic Granuloma of the Dorsum of the Tongue: A Case Report. Cureus 2023; 15:e45112. [PMID: 37842355 PMCID: PMC10569367 DOI: 10.7759/cureus.45112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Pyogenic granuloma (PG) is a common reactive oral lesion predominantly involving the gingiva and rarely occurring on the dorsum of the tongue. It can develop at any age but more commonly in the second decade with a female predilection. Numerous factors are associated with its development, and surgical removal is the standard treatment. Various surgical modalities have been used to excise it. Herein, we report a case of a female patient in her late 60s who presented with an exophytic lesion involving the dorsum of the tongue, which was excised using a 940 nm diode laser. In addition, it discusses the advantages of diode laser as a surgical modality and describes this lesion's clinical features and pathogenesis.
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Affiliation(s)
- Lubna M Al-Otaibi
- Oral Medicine and Special Care Dentistry Department, Prince Sultan Military Medical City, Riyadh, SAU
| | - Mohammed M Al-Ali
- Oral Medicine and Special Care Dentistry Department, Prince Sultan Military Medical City, Riyadh, SAU
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16
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Srinivedha CV, Simre DS, Basnet A, Pandey S, Chug A. Lobular Capillary Hemangioma Masquerading as Pyogenic Granuloma of Anterior Mandible: A Case Report. Cureus 2023; 15:e42157. [PMID: 37602023 PMCID: PMC10439000 DOI: 10.7759/cureus.42157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/22/2023] Open
Abstract
Pyogenic granuloma (PG) is a reactive connective tissue disorder with female predilection, which exhibits a tumor-like mass with occasional bleeding and superficial ulceration. It most commonly occurs in the maxillary gingiva followed by the mandibular gingiva. It can also occur in extra gingival sites like buccal mucosa, labial mucosa, and palate. There are two histopathological types of PG, namely, a lobular capillary hemangioma (LCH) variant and a non-LCH variant. The various management methods include surgical resection or laser excision along with deep curettage, and there are various nonsurgical methods like local steroid injection, topical administration of various drugs, and sclerotherapy. During the surgical excision, there is a risk of bleeding, and the surgeon should be equipped for the same. The PG (both LCH and non-LCH variant) has an increased chance of recurrence because of which complete excision is mandatory along with the removal of the local irritants. In this case report, a 28-year-old female patient reported recurrent painless swelling in the lower front gums for the past nine months. The surgical excision was done in-toto along with the removal of local irritants (calculus). The swelling was sent for histopathological examination. The patient was kept on regular follow-ups. The patient was followed up continuously for nine months. The swelling did not recur after the excision. Hence, it was concluded that complete excision and removal of local irritants are extremely crucial to prevent a recurrence.
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Affiliation(s)
- C V Srinivedha
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Dr Saurabh Simre
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Abiskar Basnet
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Sameer Pandey
- Craniomaxillofacial Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Ashi Chug
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
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17
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Bin Dlaim MS, Alhussein GA, Alqahtani RS, Almanea LT. Conservative Management of Giant Pyogenic Granuloma Post Strabismus Surgery: A Case Report and Literature Review. Cureus 2023; 15:e41321. [PMID: 37539417 PMCID: PMC10395757 DOI: 10.7759/cureus.41321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Ocular pyogenic granuloma is a benign vascular tumor that occurs primarily in children. Treatment options for pyogenic conjunctival granulomas include topical steroids, topical timolol, surgery, cryotherapy, and electrocautery. Patients with giant pyogenic granulomas are usually treated with surgical intervention. In this case, a 13-year-old Egyptian girl developed a giant pyogenic granuloma after strabismus surgery. Topical steroids showed a poor response and failed to demonstrate any improvement. While on timolol, the granuloma completely regressed, with no signs of recurrence. Despite the usual surgical approach to the treatment of purulent giant granulomas, we believe that topical timolol can be the preferred option as a noninvasive alternative therapy since it is considered safe when compared to the potential risks of topical steroid therapy or surgical exposure.
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Affiliation(s)
- Mohammad S Bin Dlaim
- Pediatric Ophthalmology Division, King Abdullah bin Abdulaziz University Hospital, Riyadh, SAU
| | - Ghadah A Alhussein
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Raneem S Alqahtani
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Leenah T Almanea
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
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18
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Lomelí Martínez SM, Bocanegra Morando D, Mercado González AE, Gómez Sandoval JR. Unusual clinical presentation of oral pyogenic granuloma with severe alveolar bone loss: A case report and review of literature. World J Clin Cases 2023; 11:3907-3914. [PMID: 37383141 PMCID: PMC10294161 DOI: 10.12998/wjcc.v11.i16.3907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Pyogenic granuloma (PG) is a localized, reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity. In most cases, the presence of this lesion does not show alveolar bone resorption. The pathology is diagnosed clinically with some caution. However, the diagnosis and treatment are usually corroborated with histopathological evidence.
CASE SUMMARY Three clinical cases of PG associated with bone loss were described in this study. The three patients presented tumor-like growth which bled on touch, and were associated with local irritant factors. Radiographs showed bone loss. All cases were treated with conservative surgical excision. The scarring was satisfactory, and there was no case of recurrence. The diagnoses were based on clinical findings, and were confirmed histopathologically.
CONCLUSION The occurrence of oral PG with bone loss is unusual. Therefore, clinical and radiographic evaluations are important for the diagnosis.
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Affiliation(s)
- Sarah Monserrat Lomelí Martínez
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
- Master of Public Health, Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Mexico
- Periodontics Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Guadalajara 44340, Mexico
| | - Dennisse Bocanegra Morando
- Periodontics Program, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Guadalajara 44340, Mexico
| | | | - Juan Ramón Gómez Sandoval
- Research Institute of Dentistry, Department of Integrated Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
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19
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Kalavathi LC, Chaitanya KV, Venkata VB. A bird's-eye view of pathologist over diagnostic confusion of oral cavity lesions. J Oral Maxillofac Pathol 2023; 27:266-274. [PMID: 37854899 PMCID: PMC10581305 DOI: 10.4103/jomfp.jomfp_312_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 10/20/2023] Open
Abstract
Introduction Oral cavity can be host to multitude of neoplastic, premalignant or non neoplastic pathological lesions. Diagnosis of lesions of oral cavity is always of interest to clinician and pathologist and rely on clinical appearance of lesions. There can be variation in diagnosis of clinical lesion with histopathology. Many oral carcinomas arise within the sites that previously had premalignant lesion. Incidence of oral cancers in population has increased among younger generations related to habits and lifestyle. These lesions during clinical presentation are misleading and create diagnostic dilemma owing to age, sex and distribution of lesions. Understanding distribution of oral mucosal lesions helps to diagnose lesions of oral cavity. Purpose of this study is to observe the variation in clinical diagnosis with histopathological diagnosis in patients with inflammatory, premalignant, benign and malignant lesions of oral cavity and oropharynx and also clinical distribution of lesions of oral cavity and oropharynx lesions by histopathology. Observations Out of total 105 lesions, ulcer in oral cavity seen in 58 (55.23%) of patients, followed by swelling or feeling of lump in oral cavity in 36 (34.29%) of patients and foreign body sensation in 23 (21.90%) of patients with tongue as most frequent site for most of lesions of oral cavity accounting in 33 (31.43%) of cases, and less frequently lesions were seen in retro molar trigone area in 2 (1.90%) patients. Histopathological diagnosis of premalignant, non neoplastic and inflammatory lesions was made in 24 (22.85%) cases, benign tumours were diagnosed in 14 (13.33%) cases and rest of 67 (63.81%) lesions were malignant. Mucocoel were seen in five (4.76%) cases, radicular cyst was seen in one (0.95%) case of female patient and four cases of Leukoplakia with one case showing mild dysplasia. Among benign tumours 11 (10.47%) patients presented with gingivitis turned out to be squamous papillomas were seen in five (4.76%) cases, fibroma was diagnosed in four (3.80%) cases, pyogenic granuloma was diagnosed in four (3.80%) cases most commonly seen over gingiva and myoepithelioma of minor salivary gland was observed in one (0.95%) case over soft palate. Out of 67 cases of malignant lesions squamous cell carcinomas were seen in 59 (88.05%) cases followed by verrucous carcinoma in 3 (4.47%) cases, 2 (2.99%) cases were basaloid squamous cell carcinomas, mucoepidermoid carcinoma was seen in 2 (2.99%) cases and 1 (1.49%) case of adenoid cystic carcinoma was seen. Majority of squamous cell carcinomas cases in study were well differentiated in 49 (73.13%) cases followed by moderately differentiated in 16 (23.88%) cases and poorly differentiated in 2 (2.99%) cases. Malignant transformation of tonsil tissue post operatively was observed in 1 (0.95%) patients on histopathology. One (2.5%) case of myoepithelioma was seen in 60 years male over soft palate. Conclusion Of all oral biopsies reported in study, increasing trend of malignancies in lower age groups of population making it an emerging threat to community and highlighting need to take effective measures to increase public awareness about risk factors and consequences of this condition. Screening programmes targeted to population over 25 years are recommended to overcome this.
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Affiliation(s)
- Lakshmi C. Kalavathi
- Department of Pathology, ACSR Government Medical College, Nellore, Andhra Pradesh, India
| | | | - Vydehi B. Venkata
- Department of Pathology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
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20
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Anwar SK, Edward SN, ELSayed NM. Diode laser versus sclerotherapy: bloodless approaches in the treatment of oral pyogenic granuloma (randomised controlled clinical trial). Odontology 2023; 111:511-521. [PMID: 36307616 PMCID: PMC10020281 DOI: 10.1007/s10266-022-00759-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022]
Abstract
Oral pyogenic granuloma (PG) is traditionally treated by surgical excision which is associated with bleeding, pain and a high rate of recurrence. Our research aimed to clinically assess the effectiveness of diode laser versus sclerotherapy, as bloodless approach, in the treatment of oral PG. We randomly divided 20 patients with oral PG into two groups, with those in the test group being managed via diode laser application and those in the control group via injections of ethanolamine oleate as a sclerosing agent. All patients were evaluated intraoperatively for bleeding severity and postoperatively for pain. The quality of healing was also assessed using Landry healing index after the 1st, 2nd and 4th weeks. Additionally, the patients were recalled after 3, 6 and 9 months from the end of treatment for recurrence evaluation. Our results revealed that intraoperative bleeding did not differ significantly between both groups while postoperative pain decreased significantly in the sclerotherapy group compared to the laser group. For different intervals, the sclerotherapy group had a higher healing quality index than the laser group, although the difference was not statistically significant. However, recurrence occurred in the laser group, there were no cases of recurrence in the sclerotherapy group in all intervals. In conclusion, diode laser treatment of PG is a reliable, less invasive, and sensitive procedure that requires an experienced operator and specialised equipment. However, ethanolamine oleate sclerotherapy is an inexpensive, simple technique besides being less prone to recurrence problems, especially when treatment duration is not a concern.
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Affiliation(s)
- Souzy Kamal Anwar
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt.
| | - Sandra Nabil Edward
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt
| | - Naguiba Mahmoud ELSayed
- Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt
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21
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Cahuana-Bartra P, Brunet-Llobet L, Suñol-Capella M, Miranda-Rius J. Expansive Oral Giant Cell Granuloma in a Pediatric Patient. Int J Clin Pediatr Dent 2023; 16:405-408. [PMID: 37519988 PMCID: PMC10373768 DOI: 10.5005/jp-journals-10005-2572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Aim This article describes a peripheral oral giant cell granuloma (POGCG) in a pediatric patient and its surgical management and histological characteristics. Background Peripheral oral giant cell granuloma (POGCG) is a hyperplastic reactive lesion formed by a proliferation of mononuclear cells and osteoclast-type giant cells in vascular tissue, occasionally with bone formation. Generally found in women and adults, POGCG has rarely been described in children. Case description An 8-year-old girl was consulted for an exophytic lesion in the anterior area of the upper jaw, which had increased in volume in the preceding weeks. An excisional biopsy of the tumor was performed with an electrosurgical pencil. The pathological diagnosis was POGCG. Conclusion Excision followed by additional therapy, such as scaling and curettage, should be the first option in the treatment of POGCG. Clinical significance Early detection of these lesions involving the periodontium is important in order to reduce bone loss and avoid pathological dental migration. How to cite this article Cahuana-Bartra P, Brunet-Llobet L, Suñol-Capella M, et al. Expansive Oral Giant cell Granuloma in a Pediatric Patient. Int J Clin Pediatr Dent 2023;16(2):405-408.
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Affiliation(s)
- Pau Cahuana-Bartra
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Lluís Brunet-Llobet
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Mariona Suñol-Capella
- 3 Department of Pathology, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain
| | - Jaume Miranda-Rius
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
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22
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Tonkaboni A, Hafezi Motlagh K, Derakhshan S. Oral focal mucinosis in an adolescent: A rare entity. Clin Case Rep 2022; 10:e6594. [DOI: 10.1002/ccr3.6594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Arghavan Tonkaboni
- Department of Oral Medicine, School of Dentistry Tehran University of Medical Sciences Tehran Iran
- Grupo de Investigacion en Patologia Oral Medico Quirurgica Universidad de Santiago de Compostela Santiago Spain
| | - Kimia Hafezi Motlagh
- Department of Oral Medicine, School of Dentistry Tehran University of Medical Sciences Tehran Iran
| | - Samira Derakhshan
- Oral and Maxillofacial Pathology Department, School of Dentistry Tehran University of Medical Sciences Tehran Iran
- Cancer Preclinical Imaging Group, Preclinical Core Facility Tehran University of Medical Sciences Tehran Iran
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23
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Hijazi LO, Asiri M, Al Mahdi MJ, Pharaon M. Pyogenic granuloma of the larynx. J Surg Case Rep 2022; 2022:rjac299. [PMID: 35794993 PMCID: PMC9252328 DOI: 10.1093/jscr/rjac299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
Pyogenic granulomas are benign, typically painless, vascular tumors of the skin and mucosal surface. Recently the term ‘lobular capillary hemangioma’ has been introduced to describe the histological appearance more accurately. Major locations for pyogenic granuloma are in the head and neck region, but larynx localization is rare. In this case report, we present a case of a 36-year-old male with lobular capillary hemangioma of the larynx and discuss the related literature.
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Affiliation(s)
- Leen Omar Hijazi
- Division of Otolaryngology-Head and Neck Surgery , Department of Surgery, Ministry of National Guard Health Affairs, , Riyadh 12221, Saudi Arabia
- King Abdullah International Medical Research Center , Department of Surgery, Ministry of National Guard Health Affairs, , Riyadh 12221, Saudi Arabia
| | - Mohammed Asiri
- Division of Otolaryngology Head & Neck Surgery, King Abdulaziz Medical City , Riyadh 12221, Saudi Arabia
| | - Mohammed Jihad Al Mahdi
- Division of Otolaryngology Head & Neck Surgery, King Abdulaziz Medical City , Riyadh 12221, Saudi Arabia
| | - Majed Pharaon
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City , Riyadh 12221, Saudi Arabia
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24
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Prajapat J, Prajapat R, Khanagar SB, Siddeeqh S. Extragingival pyogenic granuloma of the lower lip masquerading as a vascular lesion. J Oral Maxillofac Pathol 2022; 26:S119-S123. [PMID: 35450232 PMCID: PMC9017834 DOI: 10.4103/jomfp.jomfp_108_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/04/2022] Open
Abstract
Pyogenic granuloma (PG) is a benign nonneoplastic mucocutaneous lesion. It occurs as a result of chronic irritation or due to hormonal changes. The most favorable site for this fairly common lesion is gingiva, but rarely, it can occur outside the oral cavity, later often difficult to diagnose, as a diverse group of the pathologic process can produce such lesions outside the oral cavity. The diagnosis is also challenging as the lesions appear as smooth or lobulated red nodules with easy bleeding, occasionally ulcerated mimicking malignancies. The purpose of this article is to report a rare case of extragingival PG of the lower lip simulating as a vascular lesion in young male of 30 years old diagnosed by ultrasound followed by histopathological examination.
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Affiliation(s)
- Jyoti Prajapat
- Department of Oral Medicine and Radiology, Private Practitioner, Advance Dental Care Center, Gurugram, India
| | - Rajesh Prajapat
- Department of Prosthodontics Crown and Bridge, Al Jazeera Medical Complex, Riyadh, Saudi Arabia
| | - Sanjeev B Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Salman Siddeeqh
- Department of Maxillofacial Surgery and Diagnostic Science, College Dentistry, King Saud Bin Abdulaziz University for Health Science, King Abdullah International Medical Research Center, King Saud University, Riyadh, Saudi Arabia
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25
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Baddireddy SM, Akula ST, Nagilla J, Manyam R. Quantification of mast cells in oral reactive lesions - an immunohistochemical study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022219. [PMID: 36300240 PMCID: PMC9686154 DOI: 10.23750/abm.v93i5.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 02/21/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Reactive lesions (RLs) are the most common oral mucosal lesions that are benign in nature and are more likely to reoccur if the lesion or local irritants at the site are not completely removed. The histopathology is usually determined by the stage of the lesion, which includes neovascularization, inflammation, and fibrosis etc. Aim: To evaluate and compare mast cell counts in different reactive lesions with normal gingiva (NG) and to determine the correlation between mast cell count and inflammation, fibrosis, and angiogenesis using immunohistochemistry. MATERIALS & METHODS 10 pyogenic granulomas (early and late), 10 irritational fibromas, 5 inflammatory fibrous hyperplasia, and 5 peripheral cemento-ossifying fibromas 5 normal gingiva were evaluated. Mast cell counts were compared. ANOVA and t-tests were used to analyze the data. Spearman correlation was used to compare the mast cell count to the inflammation, fibrosis, and vascular components. A p-value of 0.05 was considered statistically significant. RESULTS The mean number of mast cells were increased in oral reactive lesions when compared to NG. Although mast cells were significantly higher in IFH and IF, there was no correlation found among mast cells and fibrosis/inflammation/vascularity. CONCLUSION Reactive process involves multiple interactions among mast cells, endothelial cells, fibroblasts, and other immune cells, among which the role of mast cells has been evaluated. Mast cell count increases in these reactive lesions, possibly reflecting an important role in microenvironment modification, but it is not the sole cause of these lesions' pathogenesis.
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Affiliation(s)
| | - Satya Tejaswi Akula
- Department of Oral Pathology and Microbiology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Jithender Nagilla
- Department of Public Health Dentistry, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Ravikanth Manyam
- Department of Oral Pathology and Microbiology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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26
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Swain S. A giant pyogenic granuloma on the hard palate. APOLLO MEDICINE 2022. [DOI: 10.4103/am.am_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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27
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Achalli S, Patia M. Oral pyogenic granuloma: A case report and review of literature. ACTA STOMATOLOGICA NAISSI 2022. [DOI: 10.5937/asn2285381a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Uvod: Pyogenic granuloma is a common non neoplastic growth in the oral cavity which is hyperplastic in nature. Various theories of etiopathogenesis have been suggested for pyogenic granuloma. It is commonly thought to be a response to various local irritants like calculus, foreign body material etc. It is hemorrhagic and often bleeds on touch. It usually causes local interference. Excisional biopsy is considered the treatment of choice for pyogenic granuloma followed by removal of the local irritants in order to avoid recurrence. This article presents a case of oral pyogenic granuloma in a 54-year-old patient in the gingiva extending up to the palate with a review of literature. Materials and methods: A thorough case history and clinical examination was done. A provisional diagnosis of pyogenic granuloma was given. Excisional biopsy was performed and the lesion was sent for histopathological evaluation. Result: Histopathological examination of the lesion confirmed the clinical diagnosis of pyogenic granuloma. Conclusion: Pyogenic granuloma is non neoplastic in nature and hence a detailed knowledge of this lesion is required in order to identify it in its early stage and to manage it appropriately before it causes any hindrance in normal routine functions.
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Kavitha M, Prathima GS, Vinothini V, Vigneshwari SK. Recurrent Episodes of Oral Pyogenic Granuloma at Different Site in an 8-year-old Girl: An Unusual Presentation. Int J Clin Pediatr Dent 2021; 14:730-733. [PMID: 34934292 PMCID: PMC8645614 DOI: 10.5005/jp-journals-10005-2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pyogenic granuloma is one of the benign vascular neoplasms seen in the first and second decade of life, with a female predilection. Pyogenic granuloma presents as a small reddish exophytic lesion, gingiva being the commonest site. This report presents a case of recurrent episodes of pyogenic granuloma at a different site at different time intervals in an 8-year-old girl child which was found to be an unusual presentation, and it highlights the importance of early diagnosis and management of the pyogenic granuloma to avoid the discomfort.
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Affiliation(s)
- Muthukrishnan Kavitha
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Puducherry, India
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Abstract
Severe oral inflammatory disease is not uncommon in the mouths of canine and feline patients. An approach to oral diagnosis is offered. This article discusses a brief review of important points in the oral diagnosis and management of main canine (canine chronic ulcerative stomatitis (CCUS), eosinophilic stomatitis, and Wegener's granulomatosis (WG)) and feline diseases (feline gingivostomatitis/caudal stomatitis, oral eosinophilic lesions, pyogenic granuloma, and autoimmune diseases with oral manifestations), and-whereby possible-information about the current understanding of disease pathogenesis and treatment is offered.
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Yaminian JB, Peters SM. Ulcerated gingival mass in a 45-year-old woman. J Am Dent Assoc 2021; 153:1006-1009. [PMID: 34656293 DOI: 10.1016/j.adaj.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/09/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
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Ahmad B, Ilahi I, Yousafzai AM, Attaullah M, Rahim A, Naz D, Hazrat A, Batiha GES, Nassan MA, Khalil AAK. Protective effects of Zizyphus oxyphyla on liver and kidney related serum biomarkers in (CCl4) intoxicate rabbits. BRAZ J BIOL 2021; 83:e246980. [PMID: 34468522 DOI: 10.1590/1519-6984.246980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/13/2021] [Indexed: 11/22/2022] Open
Abstract
The study was aimed to evaluate the therapeutic effects of Zizyphus oxyphyla leaves methanolic (ZOX-LME), on serum liver, kidney and hematology along with other serum parameters in Carbon tetrachloride (CCl4) intoxicated rabbits. Experimental animals were divided into five groups, six rabbits in each. These were: group NC (normal control), group, TC (toxic control) and group ST i.e. silymarine administered group at dose rate (50) mg/kg body weight (BW). Group ET1 and group ET2 treated with (ZOX-LME) at dose 200 mg/kg BW and 400 mg/kg BW. CCl4 administration caused significant (P> 0.05) impairment in serum liver enzymes, blood factors and other serum indices. Treatment with (ZOX-LME) significantly (P<0.05) reduced and normalized the levels of serum alanine transaminase (ALT) aspartate transaminase (AST) and alkaline phosphatase (ALP) and hematological indices. Also significant (P< 0.05) reduction was observed in creatinine, urea, uric acid, blood urea nitrogen (BUN), and albumin and glucose concentrations. The altered levels of lipid profile and serum electrolytes (Ca, Mg, Cl, Na, K, and P) were significantly (P<0.05) change toward normal levels with (ZOX-LME) feeding. In addition (ZOX-LME) ingestion caused significant improvement in GSH, GST and CAT levels, while reducing the TBARS levels, exhibited antioxidant capacity. Also (ZOX-LME) showed increase inhibition against percent scavenging of 2, 2-diphenile-1-picrylehydrazyle (DPPH) free radical. Significant (P<0.05) normalizing effects were observed with high dose 400 mg/kg BW of (ZOX-LME and were equivalent to silymarine administered groups. The histological study of liver supported the hepatoprotective and renal curative activity of (ZOX-LME).
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Affiliation(s)
- B Ahmad
- University of Malakand, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - I Ilahi
- University of Malakand, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - A M Yousafzai
- Islamia College, Department of Zoology, Peshawar, Pakistan
| | - M Attaullah
- University of Malakand, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - A Rahim
- University of Malakand, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - D Naz
- University of Malakand, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - A Hazrat
- University of Malakand, Departments of Botany, Khyber Pakhtunkhwa, Pakistan
| | - G E-S Batiha
- Damanhour University, Faculty of Veterinary Medicine, Department of Pharmacology and Therapeutics, Damanhour, AlBeheira, Egypt
| | - M A Nassan
- Taif University, Turabah University College, Department of Clinical Laboratory Sciences, Taif, Saudi Arabia
| | - A A K Khalil
- National University of Medical Sciences, Department of Biological Sciences, Rawalpindi, Pakistan
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Khanna SS, Munshi MAI, Kaul RN, Srinivasan S. Quandary in Diagnosing Peripheral Ossifying Fibroma and Pyogenic Granuloma: A Case Report with Mini Review. J Maxillofac Oral Surg 2021; 20:439-442. [PMID: 34408371 DOI: 10.1007/s12663-020-01359-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 03/28/2020] [Indexed: 11/30/2022] Open
Abstract
The soft tissues of the oral cavity are constantly subjected to microtrauma due to various factors. The gingiva in particular reacts to these beyond a point resulting in reactive hyperplastic lesions. Amongst these, the pyogenic granuloma and the peripheral ossifying fibroma are the most common clinical entities. Since they have a similar clinical presentation but diverse histomorphologic illustrations, it was advocated that there exists an interrelation between these two reactive fibrous overgrowths. Hence, this paper is intended to abolish the quandary in diagnosing peripheral ossifying fibroma and pyogenic granuloma.
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Affiliation(s)
- Shilpa Sunil Khanna
- Department of Oral and Maxillofacial Surgery Department, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - Meer Ahamed Ibrahim Munshi
- Department of Oral and Maxillofacial Surgery Department, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - Ronak Nazir Kaul
- Department of Oral and Maxillofacial Surgery Department, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - Sudhakar Srinivasan
- Department of Conservative Dentistry and Endodontics, Faculty of Medical Sciences and Research, Karpagam College, Coimbatore, India
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Pisano M, Sammartino P, Di Vittorio L, Iandolo A, Caggiano M, Roghi M, Bizzoca ME, Lo Muzio L. Use of Diode Laser for Surgical Removal of Pyogenic Granuloma of the Lower Lip in a Pediatric Patient: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929690. [PMID: 34146391 PMCID: PMC8218884 DOI: 10.12659/ajcr.929690] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A pyogenic granuloma is an inflammatory exophytic lesion that can occur in the oral cavity. Numerous factors are involved in the etiology of the lesion and can lead to the tissue proliferation underlying the lesion's characteristic appearance. The main treatment is surgical excision with careful curettage of the surrounding tissues. The use of a laser has been proposed because it enables performing deep and precise incisions with better hemostasis and less invasive procedures with less discomfort to patients. The aim of this study was to evaluate the possible advantages of using a diode laser in the surgical treatment of pyogenic granuloma, particularly in the management of a pediatric patient. CASE REPORT A swelling in the lower lip of an 11-year-old female patient was analyzed. After several evaluations, a 980-nm diode laser in continuous wave mode was chosen for excision of the lesion. The lesion was excised successfully with a diode laser as a conservative method that was nonstressful for the pediatric patient. CONCLUSIONS Among the techniques for surgical excision of a lesion, the use of a diode laser has the following advantages: less invasiveness, absence of intra- and postoperative discomfort and pain, effective hemostasis with better control of bleeding, absence of scarring, better postoperative management, and greater patient compliance.
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Affiliation(s)
- Massimo Pisano
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | - Pasquale Sammartino
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | | | - Alfredo Iandolo
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | - Mario Caggiano
- Department of Medicine, Surgery and Dentistry, Salerno Medical School, University of Salerno, Salerno, Italy
| | - Marco Roghi
- Italian Stomatological Institute, Milano, Italy
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Zeng X, Xia S, Yan X, Hu C, An K, Luo L. High expression of aryl hydrocarbon receptor (AhR) plays an important role in the formation of fibrous epulis. Oral Dis 2021; 28:2258-2266. [PMID: 34139032 DOI: 10.1111/odi.13940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Epulis is considered to be a massive reactive lesion rather than a true neoplasia. AhR is thought to be associated with inflammation and development of neoplasms. Here, we aimed to observe the expression of AhR in fibrous epulis and explore its role and possible mechanism in the pathogenesis of epulis. MATERIALS AND METHODS Epulis and normal gingival tissues were collected, and AhR expression was detected at the mRNA and protein levels by quantitative polymerase chain reaction (qPCR) and immunohistochemistry, respectively. The expression levels of proinflammatory cytokines and apoptosis-related factor genes in human periodontal ligament cells (hPDLCs) and human gingival fibroblasts (hGFs) transfected with AhR short interfering RNA (siRNA) or negative control siRNA, upon stimulation with lipopolysaccharide of Porphyromonas gingivalis (Pg-LPS), were then examined. Finally, the expression levels of the proinflammatory cytokines and apoptosis-related factor genes in the epulis tissues were observed by qPCR. RESULTS AhR expression in fibrous epulis was significantly increased at both the mRNA and protein levels. The expression of proinflammatory cytokines and apoptosis-related factor genes in hPDLCs transfected with AhR siRNA was significantly decreased when stimulated with Pg-LPS. The same trends were observed for hGFs. The opposite trend was detected in the epulis tissues. CONCLUSION AhR may be a key factor in fibrous epulis pathogenesis that acts by regulating the expression of BCL2 family genes and inflammatory factor-related genes.
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Affiliation(s)
- Xuwen Zeng
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
| | - Siying Xia
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
| | - Xiangzhen Yan
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
| | - Congjiao Hu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
| | - Kangkang An
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
| | - Lijun Luo
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Periodontics, School of Stomatology, Tongji University, Shanghai, China
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Abstract
BACKGROUND Pyogenic granuloma (PG) is a benign vascular lesion that is commonly observed in the skin and mucosa. Sclerotherapy is the first-line conservative treatment option for PG. OBJECTIVE This retrospective study aimed to evaluate the efficacy of sclerotherapy with 1.0% polidocanol for the treatment of PG. MATERIALS AND METHODS All patients who were clinically diagnosed with PG consecutively at the Pediatric Outpatient Service of Qilu Children's Hospital of Shandong University from March 2018 to October 2019 received sclerotherapy with 1.0% polidocanol. RESULT The procedure resulted in the complete excision of PG, with inconspicuous scars. The procedure was well-tolerated, and recurrence was not observed. Allergic reactions, cutaneous necrosis, and pigmentary changes were not observed. CONCLUSION Sclerotherapy with 1.0% polidocanol is considered an effective treatment for PGs in children. Early treatment was associated with a more favorable outcome.
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Ribeiro JL, Moraes RM, Carvalho BFC, Nascimento AO, Milhan NVM, Anbinder AL. Oral pyogenic granuloma: An 18-year retrospective clinicopathological and immunohistochemical study. J Cutan Pathol 2021; 48:863-869. [PMID: 33486806 DOI: 10.1111/cup.13970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/24/2020] [Accepted: 01/13/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Pyogenic granuloma (PG) is a lesion characterized by the proliferation of blood vessels, commonly affecting the skin and the mouth. We aimed to compare clinical, microscopic, and immunohistochemical features of the two types of oral PG: lobular capillary hemangioma (LCH) and non-LCH (NLCH). METHODS Epidemiological and clinical data from 2000 to 2018 were collected from the archives of our institution, and histopathological sections of PG were reviewed. Immunohistochemical analyses (CD34, D2-40, SMA, mast cell, and Ki-67) were performed in 34 cases. RESULTS Sixty-two LCH and 107 non-LCH samples were included. The mean (±SD) age of the patients was 38.59 ± 16.96 years; 55.62% were female; 39.64% of cases occurred in the gingiva, 44% of the nodules were pedunculated, and 13.02% of patients reported a history of trauma. NLCH was more prevalent among older patients than LCH. The most prevalent site of LCH was the lips, while NLCH occurred more in the gingiva (P < 0.05). Epithelial atrophy, microvessels, SMA-positive areas, and Ki-67-positive nuclei were more prevalent in LCH (P < 0.05). CONCLUSIONS PG accounted for 2.25% of lesions archived in the pathology service and most cases were NLCH. LCH and NLCH exhibited clinicopathological differences in terms of age, site, epithelial atrophy, vascularization, and proliferation rate.
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Affiliation(s)
- Jaqueline L Ribeiro
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Renata M Moraes
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Bruna F C Carvalho
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Anderson O Nascimento
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Noala V M Milhan
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Ana Lia Anbinder
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
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Luna-Ceron E, Gómez-Gutiérrez AK, Gonzalez-Hernandez C, Gatica-Torres M. An Uncommon Presentation of Pyogenic Granuloma. Cureus 2021; 13:e12509. [PMID: 33564515 PMCID: PMC7861056 DOI: 10.7759/cureus.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Benign vascular neoplasms are common clinical problems encountered in the practice of primary care. Pyogenic granulomas are one of the most common benign vascular lesions in young adults. Although the physiopathological mechanism for the development of this condition is still not well understood, it has been commonly associated with several triggers such as treatment with retinoids, biological agents, invasive cutaneous therapies and trauma. The development of pyogenic granulomas on sites of vascular malformations like port wine stains has been described in the literature to occur rarely. Most of these types of cases have been studied to occur in the setting of pregnancy and after cryotherapy or pulsated laser therapy. The aim of this article is to present the case of a 21-year-old man with a recent appearance of a pyogenic granuloma within an underlying port wine stain in the posterior cervical region without any history of triggers or risk factors. Excision of the vascular lesion was done, and histopathological report confirmed the diagnosis. The objective of this manuscript is to discuss the possible mechanisms involved in the development of this uncommon presentation and to summarize the current literature related to this clinical scenario.
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Affiliation(s)
- Eder Luna-Ceron
- Clinical Sciences, Tecnológico de Monterrey, Mexico City, MEX
| | - Ana K Gómez-Gutiérrez
- Clinical Sciences, Tecnológico de Monterrey, Mexico City, MEX.,Family and Community Medicine, Centro de Salud con Servicios Ampliados, Anáhuac, MEX
| | | | - Michelle Gatica-Torres
- Clinical Sciences, Tecnológico de Monterrey, Mexico City, MEX.,Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MEX
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Hegde U, Shirona A, Sreeshyla H. Evaluation of Collagen Birefringence in Oral Reactive Lesions Using Picrosirius Red Stain Under Polarized Light Microscopy: An Observational Microscopic Study. JOURNAL OF OROFACIAL SCIENCES 2021. [DOI: 10.4103/jofs.jofs_84_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cheng HS, Li J, Cheng AM. Nodule on the hand of a 13-year-old girl. Pediatr Dermatol 2021; 38:274-275. [PMID: 33630368 DOI: 10.1111/pde.14416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Harriet S Cheng
- Department of Dermatology, Auckland District Health Board, Auckland, New Zealand
| | - Jane Li
- Department of Anatomical Pathology, Auckland District Health Board, Auckland, New Zealand
| | - Anthony My Cheng
- Department of Orthopaedics, Waitemata District Health Board, Waitemata, New Zealand
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Mohd Yusof J, Abd Halim A, Wan Hamizan AK. Severe epistaxis in pregnancy due to nasal pyogenic granuloma: A case report. J Taibah Univ Med Sci 2020; 15:334-337. [PMID: 32982639 PMCID: PMC7479160 DOI: 10.1016/j.jtumed.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022] Open
Abstract
Mild to severe epistaxis is common in pregnancy and often results from increased vascularity of the nasal mucosa and hormonal changes. Symptoms may occur in the absence of an obvious local cause or any systemic disorder; however, thorough otolaryngological (i.e., “ENT”) evaluation is always warranted. Pyogenic granuloma or lobular capillary haemangioma is a benign fibrovascular proliferative tumour that is commonly found on the face, fingers, lips, and nasal mucosa. Pregnancy-induced pyogenic granuloma is not an uncommon entity and may result in torrential epistaxis if untreated. Managing a case of severe epistaxis during pregnancy usually requires multidisciplinary management. The authors present a case of severe epistaxis in pregnancy that necessitated examination of the nasal cavity under general anaesthesia. Intraoperative findings showed a bluish-red mass occupying the patient's right maxillary sinus. Bleeding was arrested and complete haemostasis was achieved. The nasal pyogenic granuloma completely resolved in the post-partum period.
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Affiliation(s)
- Johannas Mohd Yusof
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia
| | | | - Aneeza Khairiyah Wan Hamizan
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia
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41
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Nodular lesion on the posterior dorsal surface of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:e145-e150. [PMID: 32988806 DOI: 10.1016/j.oooo.2020.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/09/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022]
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Al-Noaman AS. Pyogenic granuloma: Clinicopathological and treatment scenario. J Indian Soc Periodontol 2020; 24:233-236. [PMID: 32773973 PMCID: PMC7307466 DOI: 10.4103/jisp.jisp_132_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 09/29/2019] [Accepted: 12/29/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Oral pyogenic granuloma is a soft-tissue lesion of the oral mucosa. This lesion has a tendency to reoccur after surgical excision. Materials and Methods: A total of 28 patients underwent surgical excision of pyogenic granuloma in the period from September 2014 to May 2016. Two surgical techniques were used to remove pyogenic granuloma: simple excision with root planing and modified excision with deep curettage. Results: Females (54%) were slightly more predominant than males (46%). The upper and lower jaws were almost equally affected by the lesion with more predilection toward the posterior region. The size of the lesion ranged from 0.5 to 3 cm in diameter with slow-growing rate. Rural residents were more affected (57%) than urban people. The lesion appears clinically as a small red mass with sessile base, and these clinical features were similar in pregnant and nonpregnant women. The recurrence rate was 14.8% and seen only in patients treated by simple excision. Histopathological feature was consistent with inflammatory hyperplastic lesion, and there was no radiographic evidence of bone resorption associated with the lesion. Conclusion: Modified excision with deep curettage prevents the recurrence of the lesion after 1-year follow-up.
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Affiliation(s)
- Ahmed Salah Al-Noaman
- Department of Oral Surgery, College of Dentistry, University of Babylon, Babylon, Iraq
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Lakkam BD, Astekar M, Alam S, Sapra G, Agarwal A, Agarwal AM. Relative frequency of oral focal reactive overgrowths: An institutional retrospective study. J Oral Maxillofac Pathol 2020; 24:76-80. [PMID: 32508452 PMCID: PMC7269285 DOI: 10.4103/jomfp.jomfp_350_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/22/2020] [Indexed: 12/22/2022] Open
Abstract
Context: Focal fibrous hyperplasia, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, giant cell fibroma and focal reactive overgrowth (FROGs) are one of the foremost numerous benign soft-tissue growths in the oral cavity. Chronic irritation or trauma is with identified as the causative aspect. It may develop up to few centimeters in diameter, pedunculated or sessile and may arise on the gingiva or buccal mucosa. Treatment involves surgical excision, and recurrences are infrequent. Aims: The aim of this study was to assess the prevalence of FROGs of oral mucosa in an institutional setup. Subjects and Methods: All the histopathologically diagnosed cases of FROGs within a period of 10 years (January 2008–December 2017) were retrieved from the archives of the Department of Oral Pathology. The information such as age, sex, site, anatomical side and its prevalence were recorded on customized case history performa. Statistical Analysis Used: The significance of difference was assessed using the Chi-square test and Fisher's exact test. Results: A total of 2849 cases were identified, of which 449 (15%) were FROGs. The most prevalent lesion amid them were focal fibrous hyperplasia (277, 62%), followed by pyogenic granuloma (92, 20%), whereas the least common was giant cell fibroma with 2 (0.5%) cases. All the FROGs were distributed among 21–40 years of age showing female predominance. The commonly affected site was the right buccal mucosa. Conclusions: Nevertheless, information of the frequency and distribution of these lesions is favorable when establishing a diagnosis and treatment plan in clinical practice.
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Affiliation(s)
- Bhagirathi D Lakkam
- Department of Oral Pathology and Microbiology, Sri Sai Krupa Dental Clinic, Gulbarga, Karnataka, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Shakir Alam
- Department of Oral Pathology and Microbiology, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Gaurav Sapra
- Department of Oral Pathology and Microbiology, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Ashutosh Agarwal
- Department of Oral Pathology and Microbiology, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Aditi Murari Agarwal
- Department of Oral Pathology and Microbiology, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Banjar A, Abdrabuh A, Al-Habshi M, Parambil M, Bastos P, Abed H. Labial pyogenic granuloma related to trauma: A case report and mini-review. Dent Traumatol 2020; 36:446-451. [PMID: 31869498 DOI: 10.1111/edt.12537] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Abstract
This paper reports a case of a labial pyogenic granuloma in the lower lip of a 15-year-old boy due to chronic trauma from the maxillary left central incisor. The case report is based on the CARE (CAse REport) Checklist developed by the Joanna Briggs Institute. A further aim is to present a mini-review about the link between labial pyogenic granuloma and trauma, through searching in three databases (MEDLINE, EMBASE, and Global Health) using a predefined search strategy and keywords. The Cochrane Library and PROSPERO were also searched for published and ongoing systematic reviews, respectively. Only five case reports were found that discussed the link between labial pyogenic granuloma and trauma. Chronic trauma was found to be the most common cause of pyogenic granuloma affecting the lip. Excisional biopsy was the preferable treatment due to the advantage of allowing histopathologic assessment, which is necessary to establish a definitive diagnosis. Dentists advise to include labial pyogenic granuloma in their differential diagnosis (ie, mucocele, cyst, abscess, hematoma, minor salivary gland trauma or tumor) when assessing lesions in the upper and lower lips, in particular when related to a history of trauma.
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Affiliation(s)
- Assim Banjar
- Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abrar Abdrabuh
- College of Dentistry, Al-Farabi Colleges, Jeddah, Saudi Arabia
| | - Manaf Al-Habshi
- King Faisal Hospital and Research Centre, Makkah, Saudi Arabia
| | | | - Pedro Bastos
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.,Guy's Hospital, London, UK
| | - Hassan Abed
- Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.,Guy's Hospital, London, UK
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Theofilou NE, Scolozzi P, Lombardi T. Angiolymphoid Hyperplasia with Eosinophilia Located on the Forehead: A Possible Association with Oral Contraceptive Use? Dermatopathology (Basel) 2019; 6:225-230. [PMID: 31828064 DOI: 10.1159/000503743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/29/2019] [Indexed: 11/19/2022] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign vasoproliferative tumor characterized by nodules, papules or plaques localized principally in the head and neck region. Histopathological examination reveals hyperplastic blood vessels lined by large endothelial cells, accompanied by an infiltrate of inflammatory cells including eosinophils. The pathogenetic mechanism remains unclear, although different theories have been proposed. Various treatment strategies have been described, but surgery remains the treatment of choice. We describe the case of a young woman with ALHE taking an oral contraceptive pill suggesting a possible etiopathogenetic relationship.
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Affiliation(s)
- Nantia-Eleni Theofilou
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Tommaso Lombardi
- Oral Medicine and Oral Maxillo-Facial Pathology Unit, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
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Analysis of oral pathology in an Australian paediatric population: A retrospective study. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Jiang Y, Fang B, Xu B, Chen L. The RAS-PI3K-AKT-NF-κB pathway transcriptionally regulates the expression of BCL2 family and IAP family genes and inhibits apoptosis in fibrous epulis. J Clin Lab Anal 2019; 34:e23102. [PMID: 31743516 PMCID: PMC7083487 DOI: 10.1002/jcla.23102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 01/09/2023] Open
Abstract
Background Epulis has a tumor‐like appearance but is considered to be a massive reactive lesion rather than a true neoplasia. Limited information about the pathogenesis of epulis is available. The purpose of our study was to identify potential signaling pathways in fibrous epulis through transcriptome profiling. Methods Differentially expressed genes (DEGs) between fibrous epulis lesions and normal gingival tissues were detected using RNA sequencing (RNAseq). The expression levels of eighteen genes were validated using quantitative real‐time PCR (qRT‐PCR). Results RNAseq identified 533 upregulated genes and 732 downregulated genes. The top 10 upregulated genes were IL11, OSM, MMP3, KRT75, MMP1, IL6, IL1B, IL24, SP7, and ADGRG3. The top 10 downregulated genes were BCHE, TYR, DCT, KRT222, RP11‐507K12.1, COL6A5, PMP2, GFRA1, SCN7A, and CDH19. KEGG pathway analysis further indicated that the DEGs were enriched in “Pathways in cancer” and the “Ras signaling pathway”. quantitative real‐time PCR verified that the expression levels of SOS1, HRAS, PIK3CA, AKT3, IKBKA, IKBKB, NFKB1, BCL2, BCL2L1, XIAP, BIRC2, and BIRC3 were increased significantly. Conclusions The current transcriptomic profiling study reveals that in fibrous epulis, RAS‐PI3K‐AKT‐NF‐κB pathway transcriptionally regulates the expression of BCL2 family and IAP family genes, leading to increased proliferation and apoptosis inhibition.
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Affiliation(s)
- Yangyang Jiang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Fang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Xu
- Department of Stomatology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Liang Chen
- Medical Administration Division, Ningbo Medical Center Lihuili Hospital, Ningbo, China
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A Huge Oropharyngeal Pyogenic Granuloma in a Patient Presenting with Dysphagia. Dysphagia 2019; 35:542-544. [PMID: 31489506 DOI: 10.1007/s00455-019-10057-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/21/2019] [Indexed: 10/26/2022]
Abstract
A 39-year-old woman experienced dyspnea and progressive dysphagia for 1 year. Dysphagia appeared for solid foods at the beginning but advanced for liquids. She described 17 kg weight loss in the past 6 months and her current weight was 38 kg [body mass index (BMI) 16 kg/m2]. Dyspnea presented with effort and lying was included after 1 month. There was no disease or surgery except chronic hepatitis C in her medical history. Physical examination revealed hyponasal speech and a mass beside the tongue base. A smoothly surfaced 4 × 3-cm vascular mass in oropharynx was determined in endoscopic examination. The mass was mobile and occupied 80% of oropharyngeal area. Contrast-enhanced computed tomography revealed hypervascular 4 × 4 × 3 cm pedunculated (8 × 13 mm) mass arising from the right tongue base. The mass and the surrounding mucosa with a thin layer of tongue musculature were excised using cold instrumentation and bipolar cautery. Histologically the mass was reported as pyogenic granuloma (PG). This is the first study to report on oropharyngeal PG causing obvious weight loss in literature.
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Dutra KL, Longo L, Grando LJ, Rivero ERC. Incidence of reactive hyperplastic lesions in the oral cavity: a 10 year retrospective study in Santa Catarina, Brazil. Braz J Otorhinolaryngol 2019; 85:399-407. [PMID: 29705120 PMCID: PMC9443062 DOI: 10.1016/j.bjorl.2018.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/31/2018] [Accepted: 03/15/2018] [Indexed: 10/24/2022] Open
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Abstract
BACKGROUND The aim of this study was to compare the clinical effects between traditional surgery and minimally invasive periodontal surgery in the treatment of epulis. METHODS A total of 33 cases of patients diagnosed with fibrous epulis were randomly divided into traditional surgery group and minimally invasive periodontal surgery group. After the different procedures, several parameters were detected to evaluate the effects of minimally invasive periodontal surgery. RESULTS Preoperative bleeding index and plaque index, adopt rank, and test showed no significant differences between the 2 groups. After 12 weeks, gingival papilla filling index in experiment group is statistically higher than control group, and shows the statistical differences (P < .05). The width of keratinized gingiva in experiment group grew more than that in control group, and showed the statistical differences (4.68 ± 0.30 vs 3.00 ± 0.28 mm, P < .05). No recurrence of fibrous epulis was found during the subsequent 6 months to 2 years follow-up after the surgeries. CONCLUSION Minimally invasive periodontal surgery that reserved tumor epithelium could have a better effect than the traditional surgery in the selected patients.
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Affiliation(s)
- Yaqiao Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Periodontology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei Province
- The Affiliated Huizhou Stomatologic Hospital of Medical College of Jinan University & Huizhou Stomatologic Hospital, Huizhou, Guangdong Province, P. R. China
| | - Huihui Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Periodontology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei Province
| | - Chengzhang Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Periodontology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei Province
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