Nd:YAG laser excision of a giant gingival pyogenic granuloma of pregnancy

A 19-year-old Hispanic nullipara experienced the rapid growth of an oral lesion on the right lower gingiva which she had first noticed at 29 weeks gestation. The lesion interfered with oral hygiene and eating. At surgery, the lesion measured 3.5 x 2.5 x 2.0 cm. Biopsy confirmed a pyogenic granuloma ("granuloma gravidarum"). Panorex films showed no bony invasion. The lesion was excised using the Nd:YAG laser under general anesthesia when the patient had reached 36 3/7 weeks gestation. We chose the Nd:YAG laser over the CO2 laser for the removal of this very vascular lesion, because of its superior coagulation characteristics. This technique results in removal of the lesion with less danger of bleeding than with any other surgical technique. The patient did well postoperatively, delivered a healthy 3,884 g infant at 40 6/7 weeks gestation, and has had no recurrence after 15 months of follow-up.