An alternative method for esthetic and functional management of oral pyogenic granuloma

Pyogenic granulomas (PGs) are gingival enlargements which cause esthetic and functional problems that hinder chewing and maintaining oral hygiene. In this series consisting of six cases, we report the rehabilitation of PG using partly de-epithelialized gingival grafts.

Following documentation of clinical measurements, a concurrent treatment plan of excision and reconstruction with partly de-epithelialized gingival grafts were followed for all the cases. Six months following procedures, clinical parameters were measured again and a short patient-reported outcome measures consisting of three questions were applied.

In histological evaluations, PG features were observed. In the fourth postoperative week, interdental papilla and attached gingiva were restored. Six months follow-up showed reduction in plaque and gingival indices, clinical attachment loss, and mobility. Mean keratinized tissue height was increased from 2.58 ± 2.20 to 6.66 ± 1.66 in the 6th month of operation. Oldest case was stable after 12 months of follow-up and no infection was found at grafting sites. Papillary coverage was achieved.

If the PG is not completely removed due to esthetic reservations, a recurrence may occur. Within our limitations, we can suggest that the immediate esthetic rehabilitation with partly de-epithelialized gingival graft presents a compatible approach in the treatment of mucogingival defects after aggressive excision of PG.