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05/03/2023 09:27:30 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Oral Pyogenic GranulomaSupervised By:Dr-Ahmed TalebBDS M.Sc Peridontology
Dr-Muthanna Ibraheem
BDS
Dr-Moamen Mowafaq
BDS
Done By
05/03/2023 09:27:30 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Common Inflammatory
hyperplasia. Non-neoplastic. painless.
The name is a misnomer since
• no pus • not granuloma.
Introduction Tumorlike. Nodular growth in
the oral cavity.
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Surface: • usually ulcerated Color:• red-to-purple. smooth or lobulated pedunculated or sessile. soft to palpation.
Size: • vary in from a few millimeters to several centimeters
Clinical feature
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Early lesions : bleed easily extreme vascularity. Mature lesions: the vascularity decreases more collagenous pink.
Clinical feature
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Later lesions : fibrous maturation resemble and/or become fibromas.
can have a rapid growth pattern that can cause alarm.
Clinical feature
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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clinically identical to, peripheral ossifying fibroma and peripheral giant cell granuloma.
These two lesions: only on the gingiva or alveolar mucosa PG : anywhere . Same : clinical appearance, treatment, and prognosis
Clinical feature
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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75% on the gingiva, Most frequently: buccal
gingiva _interproximal tissue.
In The maxillary gingiva (especially anterior region)
more than the mandibular gingiva;
Location:
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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The facial gingiva more than the lingual gingiva. Some lesions affect
both the facial and lingual gingivae.
Location:
05/03/2023 09:27:31 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Also in : the lips, tongue (especially the dorsal surface), and buccal mucosa.
Location:
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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extragingival : A history of trauma gingiva : irritation.
Most in Individuals with chronic oral irritants (eg, overhanging
restorations, calculus) poor oral hygiene and Hormonal change Implantitis, around an implant.
Causes
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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International Lesions have a similar frequency throughout
the world.
Race No racial predilection is reported.
Age any age, most frequently affect young
adults.
Epidemiology
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Females more susceptible than males.
because of the hormonal changes
during puberty, pregnancy, and menopause.
Also called a "pregnancy tumor“ occur in 1% of pregnant women.
Sex
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Radiography findings are negative.
If calcifications are present, then the lesion probably is a peripheral ossifying fibroma,
Imaging Studies
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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This lesion is a reactive/inflammatory process.
ulcerated mucosa parakeratotic or non-
keratinized SSE.Core: lobulated cellular
Histology
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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fibrous connective tissue
proliferation of vascular channels.
Few collagen. inflammatory
infiltrate ( by plasma cells, lymphocytes and neutrophils)
Histology
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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conservative surgical excision to the periosteum
scaling adjacent teeth to remove any calculus and plaque.
Management
05/03/2023 09:27:32 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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05/03/2023 09:27:33 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Alternative protocols:
Nd:YAG Laser Cryosyrgery Intralesional injection of ethanol or
corticosteroid. Sclerotherapy.
Management
05/03/2023 09:27:33 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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In pregnant women: When possible, wait after delivery to
remove the lesion. because of a greater tendency for
recurrence during pregnancy. In a number of cases, mastication on the
lesion causes bleeding and pain and requires surgical intervention before parturition.
Some lesions regress after childbirth without surgical intervention.
Management
05/03/2023 09:27:33 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Prevention: routine dental cleanings and home care,
especially during pregnancy.
Complications: No complications ,only chance of a cosmetic
gingival defect.
Management
05/03/2023 09:27:33 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Prognosis: excellent, usually does not recur unless inadequately
removed. The recurrence rate is higher during pregnancy.
Patient Education: Focus on better oral hygiene.
Management
05/03/2023 09:27:33 AMالمركز التخصصي لطب األسنان في بعقوبة الجديدة
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Thank You