Occurrence of a Pyogenic Granuloma in Relation to a Dental Implant

Abstract

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.

Co-development of pyogenic granuloma and capillary hemangioma on the alveolar ridge associated with a dental implant: a case report

“…However, some serious complications related to dental implant placement, including hemorrhage and life-threatening swelling, have occasionally been reported [1]. In addition, the unexpected development of benign mucosal diseases, such as pyogenic granuloma (PG) or peripheral giant cell granuloma, that are associated with dental implants has been reported in several cases [2-6]. The etiology of these mucosal diseases related with dental implants has not been determined; however, chronic irritation due to corrosion of the fixture surface and chronic inflammation may be considered contributing factors to their pathogenesis [3].…”

Implantologie et pathologies de la muqueuse buccale : une revue de la littérature

“…L'analyse de la littérature rapporte des cas cliniques relatifs au développement postimplantaire de deux pathologies : − des granulomes pyogéniques [27,28] ; − des granulomes périphériques à cellules géantes [28][29][30][31][32][33][34][35].…”

“…Les données de la littérature sur les cas cliniques de granulomes pyogéniques postimplantaires sont résumées dans le tableau V. Dojcinovic et al rapportent un cas de granulome pyogé-nique postimplantaire lié à un pilier de cicatrisation trop large, entraînant une irritation chronique de la gencive péri-implantaire [27].…”

“…Ces granulomes pyogéniques sont souvent favorisés par un traumatisme local (30-50 % des patients) expliquant la possibilité d'observer de telles lésions après la pose d'implants [27].…”

Histopathological Spectrum of Bone Lesions Associated with Dental Implant Failure: Osteomyelitis and Beyond

“…Pathological lesions that develop in the soft tissue adjacent to dental implants are usually of the inflammatory, plaque-induced type (i.e., peri-implant mucositis) [2,3] and seldom of the reactive type (i.e., peripheral giant cell granuloma and pyogenic granuloma) [4,5]. There have been less than twenty documented cases of primary squamous cell carcinoma that have developed in the soft tissues of the alveolar ridge surrounding dental implants, occasionally with a component involving the bone surrounding the implant or presenting as primary intraosseous squamous cell carcinoma adjacent to a dental implant [6].…”