Intraoral lobular capillary hemangioma in the esthetic zone

Lobular capillary hemangioma (LCH), previously known as pyogenic granuloma, is a benign vascular lesion commonly affecting the oral cavity. Despite its misleading name, LCH represents a reactive hyperplastic proliferation of capillaries, often triggered by local irritation or hormonal changes. A 30-year-old male presented with a painless, fibrous, pedunculated swelling between the maxillary central incisors, causing pathological tooth migration and difficulty in mastication. Clinical and radiographic examination revealed no bony involvement, and a provisional diagnosis of LCH was made. The lesion was surgically excised, followed by placement of a collagen matrix (Mucograft®) to augment the soft tissue defect. Histopathological examination confirmed LCH, which revealed proliferating capillaries and mixed inflammatory infiltrates. Postoperative healing was uneventful, with reduced tooth flaring and improved probing depth at the 8-month follow-up. This case highlights the importance of accurate diagnosis and management of LCH, particularly in esthetic zones, where soft tissue augmentation aids in optimal functional and cosmetic outcomes. Surgical excision with adjunctive grafting minimizes recurrence while preserving gingival architecture.