Pyogenic Granuloma

Pyogenic granuloma represents an over-exuberant tissue reaction to some known stimuli or injuries. The term pyogenic granuloma is somewhat a misnomer since the condition is not associated with pus formation.

Age: occurs at an early age.
Sex: seen more frequently in females.
Site: mostly occurs in relation to the gingiva, however on rare occasions, other mucosal sites may be involved.

• The lesion appears as a small, pedunculated or sessile, painless, soft, lobulated growth on the gingiva

• Labial surface of the gingiva is more frequently affected than the lingual surface.

• The lesion is often ulcerated and bleeds profusely, either upon provocation or spontaneously.

• The ulcerated area of the lesion is often covered by a yellow fibrinous membrane.

• The rate of growth of the lesion is very rapid and its maximum size could be up to 1 cm in

•Untreated lesion of pyogenic granuloma undergoes fibrosis due to decreased vascularity and in such cases it appears small, firm with little tendency to bleed. This lesion is called “fibroepithelial polyp”

• Similar lesions appearing on the gingival tissue of pregnant women are known as “pregnancy tumor”.

• Histologically, the lesion is composed of lobular masses of hyperplastic granulation tissue, containing multiple proliferating fibroblasts, many blood capillaries and a variable number of chronic inflammatory cells.

• The lesion is a vascular one and it occurs due to the proliferation of the endothelial cells.

• The overlying epithelium is thin and ulcerated, and in most of the cases the underlying
connective tissue shows intercellular edema.

• Areas of hemorrhage and hemosiderin pigmentation are often seen within the connective tissue stroma.

Pyogenic granuloma is treated by surgical excision.