Peripheral giant cell granuloma associated with a dental implant. A case report

Peripheral giant cell granuloma (PGCG) is a tumor-like pathologic condition arising on the buccal or lingual attached gingival or alveolar mucosa and the crest of the edentulous alveolar ridge, of uncertain etiology; it is probably a reactive lesion caused by chronic local irritants or trauma rather than a true neoplasm. PGCG is thought to originate from elements of the periodontal ligament or from the periosteum. Clinically, it appears as a sessile or broadly pedunculated, bluish to purple-red, fleshy or firm swelling with a frequently ulcerated surface. The occurrence of such a lesion may be significant for the prognosis of dental implants, and they can lead to integration failure. Treatment of choice is conservative surgical excision with total removal of the base of the lesion and with curettage of the underlying bone. However, some of these lesions recur. Clinically, it may be difficult to distinguidsh PGCG from pyogenic granuloma. Moreover, also peripheral odontogenic tumors have to be considered in the differential diagnosis of PGCG. The clinical appearance of all these lesions are similar and so the definitive diagnosis is only histological and a biopsy with micreoscopical examination is mandatory.