Since initially described, the terms "pyogenic granuloma" (PG) and "lobular capillary hemangioma" (LCH) have undergone a significant change in meaning, which leads to a confusion in the literature. In this study, we attempted to investigate if there are any clinical and pathological differences between the pyogenic granuloma and lobular capillary hemangioma through a scoping review of the available literature. A Medline search has identified 342 articles from 2001 to 2018, from which English papers, case series, retrospective studies, and cross-sectional studies were selected. Data from the articles was charted using appropriate subheadings for the clinical question (e.g., number of patients, clinical features, histology, pathogenesis, differential diagnosis, treatment). Compared to LCH, PG seems to occur more in the middle-aged range, has a clearer predilection for (pregnant) females, and has more frequently a known triggering factor in the history. Histologically, PGs appear as radially organized capillaries (while LCHs have a lobular pattern), have a mixed inflammatory infiltrate (compared to the occasional lymphocytic infiltrate in LCHs), and can undergo fibrosing transformation when chronic, which is not seen in LCHs. Finally, besides basic excision, several other treatment options have been described for both lesions. Since the pyogenic granuloma and lobular capillary hemangioma show clinical and pathological differences, we propose them to be considered as distinct lesions, which makes interpreting the literature much easier.

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ObjectiveThe purpose of this study was to describe the complications following orthognathic surgery in patients with rheumatic diseases and to evaluate rheumatic disease as a possible risk factor.MethodsA retrospective cohort study was conducted during a 6‐year period. The sample consisted of rheumatic and healthy patients who underwent orthognathic surgery. The outcome variables included infection, relapse, respiratory complications, hemorrhage, neurosensory disturbances, temporomandibular joint complications, and removal of osteosynthesis material. Bivariate analysis and logistic regression were applied to identify rheumatic disease as an independent risk factor for complications after orthognathic surgery.ResultsTwenty patients were identified as having rheumatic diseases (male: 2; female: 18; mean age: 37.8 ± 13.6 years), and 278 patients were systemically healthy (male: 105; female: 173; mean age: 25.8 ± 11.8 years). The most frequent complications in rheumatic and healthy patients were delayed recovery from neurosensory disturbance (55% and 33%), removal of osteosynthesis material (45% and 26%), and infection (35% and 7%). Following adjustment for possible confounders, rheumatic disease showed a significant association with infection (OR = 4.191, p = 0.016).ConclusionPatients with rheumatic diseases are at a higher risk of postoperative infection following orthognathic surgery compared to healthy patients.

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