Common Reactive Lesions of the Gingiva
TABLE 1: Clinical and histopathologic categorization of reactive gingival lesions.
CLINICAL APPEARANCE
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HISTOPATHOLOGY
PYOGENIC
GRANULOMA Erythematous, lobular lesion
with frequently ulcerated surface.
Although non-painful, they bleed
easily due to the increased vascularity.
Associated with pregnancy and
hormonal changes. They can grow
to be several centimeters in size. A lobular proliferation of endothelial
lined vascular channels. The stroma
may be edematous and inflamed.
PERIPHERAL
FIBROMA Asymptomatic, pink, dome-shaped
nodule with a smooth surface. Most
are less than 1.5 cm in size. A well-defined proliferation of dense
collagenous tissue and scattered
bland-appearing fibroblasts within the
connective tissue. Multinucleated giant
cells may be present in some cases.
PERIPHERAL
OSSIF YING
FIBROMA Red to pink, dome-shaped mass,
frequently with an ulcerated surface.
Most are less than 2.0 cm in size. A nodular proliferation of plump
fibroblasts with hard-tissue formation.
Osteoblasts and multinucleated giant
cells may be present around the
hard tissue, which can be bone,
cementum-like material, or dystrophic
calcifications.
PERIPHERAL
GIANT CELL
GRANULOMA Red to bluish-purple, dome-shaped
mass. May cause resorption of
underlying alveolar bone. A nodular proliferation of multi-nucleated
giant cells with intervening plump
mesenchymal cells, inflammatory
cells, and areas of fresh hemorrhage.
Calcifications may also been seen.
MAY/JU NE 2018 | P EN N S YLVA N IA D EN TA L J O UR N A L