Pyogenic granuloma: Clinicopathological and treatment scenario
Journal name: Journal of Indian Society of Periodontology
Original article title: Pyogenic granuloma: Clinicopathological and treatment scenario
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Ahmed Salah Al-Noaman
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Pyogenic granuloma: Clinicopathological and treatment scenario
Year: 2020 | Doi: 10.4103/jisp.jisp_132
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Pyogenic granuloma is a nonneoplastic soft-tissue lesion predominantly found in the oral cavity, characterized by its inflammatory nature. It primarily affects the gingiva but can also occur in other areas such as the lip, tongue, and buccal mucosa. Commonly seen in young adult females, this condition often arises due to local irritants, hormonal changes, and certain systemic factors. Surgical excision remains the favored treatment method, though recurrence rates can vary from 5.8% to 16% post-surgery. This study aims to explore the clinicopathological aspects of pyogenic granuloma and evaluate the recurrence rate following two different surgical techniques.
Surgical Techniques and Recurrence Rate
The study involved 28 patients who underwent surgical excision of pyogenic granuloma using two techniques: simple excision with root planing and modified excision with deep curettage. Results indicated that the recurrence rate was higher in the simple excision group (14.8%) compared to the group that underwent modified deep curettage, which showed no recurrences after a one-year follow-up. This suggests that the thorough removal of the lesion and adjacent tissue during the modified technique helps prevent recurrence effectively. The histopathological examination revealed inflammatory hyperplastic lesions without any evidence of bone resorption, further supporting the efficacy of the modified surgical approach.
Conclusion
The findings of this study underscore the propensity of pyogenic granuloma to affect females, particularly in their fourth decade of life and more commonly among rural residents. The condition is typically localized in the posterior regions of the jaws. Importantly, clinical features do not differ significantly between pregnant and nonpregnant women. The successful application of modified excision with deep curettage indicates its superior effectiveness in managing pyogenic granuloma and reducing recurrence rates, affirming the necessity of complete excision in surgical treatment protocols.
FAQ section (important questions/answers):
What is pyogenic granuloma and where does it occur?
Pyogenic granuloma is a nonneoplastic soft-tissue lesion primarily affecting the oral mucosa, particularly the gingiva. It can also appear on other sites such as the lips, tongue, and buccal mucosa due to inflammatory reactions.
What surgical techniques were used to treat pyogenic granuloma?
Two surgical techniques were employed: simple excision combined with root planing and modified excision with deep curettage. The latter aimed to prevent recurrence by removing more surrounding tissue and ensuring thorough cleaning of the lesion.
What was the recurrence rate after treatment for pyogenic granuloma?
The study found a recurrence rate of 14.8% among patients treated with simple excision. In contrast, patients who underwent modified excision with deep curettage showed no recurrences during the one-year follow-up.
What factors contribute to the development of pyogenic granuloma?
Factors include local issues like poor oral hygiene, retained roots, and chronic irritation, as well as systemic influences like hormonal changes during pregnancy or puberty followed by certain medications such as cyclosporine.
How does the appearance of pyogenic granuloma vary in patients?
Clinically, pyogenic granulomas often present as small red masses on a sessile base, with potential similarities between pregnant and non-pregnant women. The lesions are typically painless but may bleed easily due to high vascularity.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Pyogenic granuloma: Clinicopathological and treatment scenario”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In the context of the study, 'Table' refers to structured data presentations that summarize findings, such as the distribution of lesions across different demographic groups. They facilitate quick assessment of key results, allowing for immediate comparisons, and serve an essential role in clarifying complex information visually for the audience.
2) Study (Studying):
The term 'Study' indicates a systematic investigation into oral pyogenic granuloma, involving data collection, analysis, and comparison of different surgical techniques. It provides insights into trends, recurrence rates, and etiology, contributing valuable knowledge that can guide clinical practices and improve treatment outcomes for patients.
3) Relative:
Here, 'Relative' may refer to comparisons between genders or between urban and rural residents in the study. Understanding these relationships helps identify risk factors for pyogenic granuloma, as well as differences in prevalence and characteristics, ultimately aiding healthcare providers in tailoring interventions based on demographic information.
4) Pregnant:
'Pregnant' specifically identifies a subset of patients that often show unique physiological changes influencing the development of oral pyogenic granulomas. By focusing on this group, the study can explore how hormonal fluctuations and other physiological conditions during pregnancy affect lesion formation, treatment options, and recurrence rates.
5) Hygiene (Hygienic):
'Hygiene' relates to the status of oral cleanliness among patients, highlighting its role as a significant contributing factor for the occurrence of pyogenic granuloma. Poor oral hygiene can exacerbate irritants leading to lesion formation, thus illustrating the necessity for effective dental care and preventative measures in at-risk populations.
6) Male:
This term identifies the male demographic within the study's patient population. Understanding the gender distribution, with fewer male patients than female, may indicate hormonal or behavioral influences on the incidence of pyogenic granuloma, guiding further research in gender-specific treatment and prevention strategies.
7) Life:
'Life' can refer to the various life stages during which individuals may be affected by pyogenic granuloma. The study sheds light on the age distribution of affected patients, revealing that younger adults are predominantly impacted, which could relate to lifestyle and biological factors, necessitating targeted awareness efforts.
8) Inflammation:
'Inflammation' signifies the biological response to irritation and is a core pathology underlying conditions like pyogenic granuloma. The study delves into inflammatory processes, documenting histopathologic findings that support the characterization of the lesion, guiding treatment choices, and addressing broader inflammatory responses in oral health.
9) Surface:
In the study, 'Surface' pertains to the characteristics of the pyogenic granuloma, which may appear smooth or ulcerated. This distinction is essential for diagnosis and treatment planning, as surface features can inform clinicians about the duration and nature of the lesion, influencing surgical and therapeutic decisions.
10) Rules:
'Rules' may refer to the procedural guidelines or standards followed in conducting the study. Adhering to established protocols ensures the reliability of data, ethical standards, and reproducibility in the research process, which is crucial for obtaining credible findings and fostering trust in scientific inquiry.
11) Discussion:
'Discussion' represents a critical section within the study where the authors interpret results, linking findings to prior research and theoretical frameworks. This section contextualizes the study's implications, exploring how the results can influence clinical practices and suggestions for future research directions, enriching the scientific dialogue.
12) Irritation:
'Irritation' concerns the local physical or chemical damage to tissues, contributing to the etiology of pyogenic granuloma. The study evaluates various irritation sources—like dental calculus or trauma—and their role in lesion development, informing targeted prevention strategies and improving understandings of lesion triggers.
13) Evolution:
'Evolution' in the study context refers to the progressive development of pyogenic granuloma over time, both in terms of clinical presentation and recurrence. Recognizing the growth patterns and changes in lesions helps clinicians predict outcomes and develop effective management strategies to mitigate recurrence after treatment.
14) Babylon:
'Babylon' refers to the location where the study was conducted. Contextualizing the geographical aspect of the research highlights potential variations in disease prevalence, healthcare access, and local practices, which are crucial for understanding regional differences in the incidence and management of oral diseases like pyogenic granuloma.
15) Filling (Filled):
'Filling' likely pertains to dental restorations that may be associated with pyogenic granulomas, either as causative factors due to trauma or as subjects of assessment during surgery. This term underlines the complexity of oral health management, where previous dental work can impact the appearance and treatment of lesions.
16) Blood:
'Blood' relates to the vascular characteristics of pyogenic granuloma, which is rich in blood vessels. This vascularity underlies the lesion's clinical presentation, influencing its tendency to bleed easily and necessitating careful surgical strategies to manage bleeding and achieve effective healing during treatment.
17) Mast:
'Mast' refers to mast cells, which play a vital role in the inflammatory response related to pyogenic granuloma development. These cells release mediators that can enhance vascular responses, thus contributing to the lesion's etiology. Understanding their function can inform treatment approaches targeting inflammation and vascularity within the lesion.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Pyogenic granuloma: Clinicopathological and treatment scenario’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Pregnant women, Oral hygiene, Clinical feature, Surgical excision, Local anesthesia, Etiology, Age-group, Recurrence Rate, Histopathological examination, Recurrence prevention, Surgical technique, Size of the lesion, Females, Rural Residents, Posterior region.