Oral Pyogenic Granuloma Associated With a Dental Implant Treated With an Er:YAG Laser: A Case Report
A pyogenic granuloma is a tumorlike proliferation that occurs slightly more often in females, frequently involving the gingiva in the maxillary region. Clinically, it presents as a sessile or pedunculated exophytic mass with a smooth or lobulated surface, which tends to bleed easily. Its color can range from pink to dark red. The most common treatment is surgical excision. This case report presents a pyogenic granuloma that formed around an implant 7 years after its insertion. Pyogenic granulomas associated with dental implants are extremely rare; this is the fourth reported case and the first case of pyogenic granuloma to be treated with an Er:YAG laser.
(a) Patient with unilateral lip and palatal cleft. (b) The cleft area was grafted with an autogenous block graft, which was harvested from the mandibular retromolar region. (c) The defect was augmented vertically by alveolar distraction osteogenesis. (d) Two dental implants were placed. (e) The buccal region was grafted with keratinized gingival tissue. (f) Metal-supported porcelain restorations were constructed and adapted to the implants.
Figure 2. (a) The lesion 2 × 1.5 cm in diameter was around the implants on both vestibular and palatal gingiva. (b) Radiographic examination showed a resorption gap between the implants and 2 mm of horizontal bone loss. (c) The lesion was excised, and decontamination was performed with the Er-YAG laser. (d) Microscopic examination showed an ulcerated granulation tissue containing several capillaries intermingled with numerous neutrophils (hematoxylin and eosin, original magnification ×20). Figure 3. After 2-year follow-up, no recurrence was observed.
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