Occurrence of a pyogenic granuloma in relation to a dental implant.
Pyogenic granuloma is an inflammatory vascular hyperplasia often occurring in the oral cavity. It appears in response to various stimuli such as low-grade local irritation, trauma, or female steroid hormones. A 32-year-old man sought care for a tender and bleeding lesion of the left posterior maxillary gingiva. The intraoral examination showed an exophytic ulcerated nodule measuring 1.0 cm, related to a dental implant placed in the upper left second premolar position. Radiographic examination showed an oversized healing cap. A provisional diagnosis of reactive inflammatory hyperplasia was made, and the lesion was excised and submitted for histologic examination. On microscopy, the surgical specimen showed an ulcerated nodule consisting of a delicate connective tissue stroma containing numerous blood vessels with plump endothelial cells, intermingled with abundant polymorphonuclear lymphocytes. A diagnosis of pyogenic granuloma associated with a dental implant was made. In this case it was the result of an inappropriate choice of a healing cap, thus allowing an accumulation of dental plaque and sustained chronic inflammation of the peri-implant tissue. A conservative excision and replacement of the healing cap were sufficient for definitive treatment.
Dojcinovic
Ivan
I
Clinic of Maxillofacial and Oral Surgery, Geneva University Hospitals, Geneva, Switzerland. dojcinovic@hotmail.com
Richter
Michel
M
Lombardi
Tommaso
T
D000328:Adult; D015921:Dental Implants / Q000009:adverse effects*; D017267:Dental Prosthesis Design / Q000009:adverse effects; D003937:Diagnosis, Differential; D005882:Gingival Diseases / Q000209:etiology* / Q000473:pathology; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology; D017789:Granuloma, Pyogenic / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008437:Maxilla
D015921:Dental Implants