Öz
Amaç: Bu çalışmanın
amacı, 12 yaşında bir kız çocuğunda görülen piyojenik granülomanın tedavisinin
ve 12 aylık takip sürecinin değerlendirilmesidir.
Olgu bildirimi: Piyojenik
granüloma vasküler tümörler içinde yer alan bir lezyondur. Gingivadaki bütün
reaktif lezyonların %30-60’ını teşkil eder. Piyojenik granülomanın gelişmesinde
travma, damar duvarı enfeksiyonları, hormonal faktörler, yabancı cisimler,
hipertansiyon ve zayıf oral hijyenin etken olduğu bildirilmektedir. Tüm yaş
gruplarında ve her iki cinste de görülebilir. Oral kavite de piyojenik
granüloma lezyonlarına en sık gingivada rastlanır. Kesin tanı sadece biyopsisi
alınan dokunun histopatolojik incelenmesi ile konulabilir. Bu lezyonun tedavisi
cerrahi eksizyondur. Yeterli bir cerrahi eksizyon yapılmazsa lezyonun
tekrarlama riski vardır.
12 yaşındaki kız
çocuğu üst çene anterior palatinal bölgesindeki dişetinde şişlik ve bu bölgede
kanama şikayetleri ile kliniğimize başvurdu. Başlangıç tedavisi olarak hastaya
oral hijyen eğitimi verildi, plak ve diş taşları uzaklaştırıldı. Lezyonun
ağızda görülebilecek diğer patolojik oluşumlardan ayırıcı tanısını yapabilmek
için lokal anestezi altında bisturi yardımıyla eksizyonel biyopsi ile alındı.
Maksillada ek olarak frenektomi operasyonu, mandibulada ise oral hijyen koşullarını
daha rahat sağlaması için vestibül derinleştirme operasyonu yapılmıştır. Hastanın
üç aylık takibi sonucu palatinal bölgedeki dişeti büyümelerinin tekrar oluştuğu
görülmüştür. Bunun sonucunda tekrar gingivektomi operasyonu
gerçekleştirilmesine karar verilmiştir. Gerçekleştirilen gingivektomi
operasyonu sonrasında hasta oral hijyen konusunda teşvik edilip kontrol
randevularına çağrıldı.
Sonuç: Eksizyonel
biyopsi sonrasında ışık mikroskobu altında histopatolojik olarak incelenen
kitleye “Piyojenik Granüloma” tanısı konuldu. Kontrol muayenesinde klinik
olarak herhangi bir nüks mevcut değildi.
Anahtar
Kelimeler: piyojenik
granüloma, eksizyonel biyopsi
Anahtar Kelimeler
Kaynakça
- 1. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167–75.
- 2. Ramirez. K, Bruce G, Carpenter W. Pyogenic granuloma: case report in a 9-year-old girl. General Dentistry. 2002;50 (3):280-81.
- 3. Hullihen SP. Case of aneurism by anastomosis of the superior maxillae. Am J Dent Sci 1844;4:160‑2.
- 4. Yaan K, Jin YT, Lin MT. Expression of Tie2, angiopoietin-1, angiopoietin-2, ephrin B2 and Eph B4 in pyogenic granuloma of human gingival implicates their role in inflammatory angiogenesis. J Periodontal Res 2001; 35: 165.
- 5. Angelopulos AP. Pyogenic granuloma of the oral cavity: Statistical Analysis of its clinical features. J Oral Surg 1971; 29: 890.
- 6. Lever VF, Lever GS. Histopathology of the skin. 13. Lpincolt Co, 1990: 698.
- 7. Neville BW, Damm DD, Allen CM, et al. Oral & maxillofacial pathology. 2nd edn. Philadelphia: WB Saunders, 2002:437–95.
- 8. Eversole LR. Clinical outline of oral pathology: diagnosis and treatment. 3rd edn. Hamilton: BC Decker, 2002:113–14.
- 9. Aguilo L. Pyogenic granuloma subsequent to injury of primary tooth: a case report. Int J Paed Dent 2002;12:438–41.
- 10. Shenoy SS, Dinkar AD. Pyogenic granuloma associated with bone loss in an eight-year-old child: a case report. J Indian Soc Pedod Prev Dent 2006;24:201–3.
- 11. Bhaskar SN, Jacoway JR. Pyogenic granulom: clinical features, incidence, histology, and result of treatment: report of 242 cases. J Oral Surg 1966; 245: 391-8.
- 12. Al-Khateeb T, Ababneh K. Oral pyogenic granuloma in Jordanians: a retrospective analysis of 108 cases. J Oral Maxillofac Surg 2003;61:1285-8.
- 13. Regezi JA, Sciubba JJ, Jordan RC. Oral Pathology: Clinical Pathological Considerations. 4th ed. Philadelphia: WB Saunders; 2003. p. 115‑6.
- 14. Gordón-Núñez MA, de Vasconcelos Carvalho M, Benevenuto TG, Lopes MF, Silva LM, Galvão HC. Oral pyogenic granuloma: a retrospective analysis of 293 cases in a Brazilian population. J Oral Maxillofac Surg 2010;68:2185-8.
- 15. Jafarzadeh H, Sanatkhani M, Moshtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167–75.
- 16. Sills ES,Zegarelli DJ, Hoschander MM, Strider WE. Clinical diagnosis and management of hormonally responsive oral pregnancy tumor (pyogenic granuloma). J Reprod Med 1996;41:467-70.
- 17. Fowler EB, Cuenin MF, Thompson SH, Kudryk VL, Billman MA. Pyogenic granuloma associated with guided tissue regeneration: a case report. J Periodontol 1996; 67: 1011-5.
- 18. Wandera A, Walker PO. Bilateral pyogenic granuloma of the tongue in graft-versus-host disease: report of case. ASDC J Dent Child 1994; 61: 401-3.
- 19. Anderson WAD, Scatti MT. Skin. In Synopsiss of Pathology. Cv Mosby Co. 1980: 681.
- 20. Davies MG, Marks R. Dermo-epidermal relationships in pyogenic granulomata. Br J Dermatol 1978; 99: 503-12.
- 21. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006; 48(4): 167-75.
- 22. Mathur LK, Bhalodi AP, Manohar B, Bhatia A, Rai N, Mathur A. Focal fibrous hyperplasia: a case report. Int J Dent Clin 2010; 2(4):6-7.
- 23. Kerr DA. Granuloma pyogenicum. Oral Surg Oral Med Oral Pathol 1951; 42: 158.
- 24. Ramirez. K, Bruce G, Carpenter W. Pyogenic granuloma: case report in a 9-year-old girl. General Dentistry. 2002;50:280-81.
- 25. Karthikeya P, Mahima VG, Lahari K. Exragingival pyogenic granuloma. Indian J Dent Res. 2006;17:199-202.
- 26. Graham RM. Pyogenic granuloma: an unusual presentation. Dent Update. 1996;23:240-41.
- 27. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006;48:167-75.
- 28. Greenberg MS, Glick M. Burket’s oral medicine: diagnosis and treatment. 10th edn. Hamilton: BC Decker, 2003:141–2.
- 29. Ichimiya M, Yoshikawa Y, Hamamoto Y, et al. Successful treatment of pyogenic granuloma with injection of absolute ethanol. J Dermatol 2004;31:342–4.
- 30. Moon SE, Hwang EJ, Cho KH. Treatment of pyogenic granuloma by sodium tetradecyl sulfate sclerotherapy. Arch Dermatol 2005;141:644–6.
- 31. Patrice SJ, Wiss K, Mulliken JB. Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. Pediatr Dermatol 1991, 8: 267-276
- 32. Tay Y-K, Weston WL, Morelli JG. Treatment of pyogenic granuloma in children with the flashlamp-pumped pulsed dye lazer. Pediatrics 1997;99:368-70.
- 33. Pagliai KA, Cohen BA. Pyogenic granuloma in children. Pediatr Dermatol 2004, 21: 10-3.
- 34. Lee CT, Tham SN, Tan T. ›n›t›al experience with CO2 laser in treating dermatological conditions. Ann Acad Med Singapore 1987;16: 713-5.
- 35. Krishnapillai R, Punnoose K, Angadi PV, Koneru A. Oral pyogenic granuloma-a review of 215 cases in a South Indian Teaching Hospital, Karnataka, over a period of 20 years. Oral Maxillofac Surg 2012;16:305-9.
Öz
Purpose: The purpose of this study is to evaluate the treatment
and pursuit process of the pyogenic granuloma which has seen on 12 years old
girl patient.
Case Presentation: Pyogenic granuloma is a lesion which classified
in vascular tumors which constitute 30-60% of all the reactive lesions of
gingival tissue. Trauma, infections of capillary wall, hormonal factors,
foreign materials, hypertension and poor oral hygiene are accused for
development of pyogenic granuloma. It may occur at all age groups and in both
sexs. In the oral cavity, pyogenic granuloma lesions are most frequently
encountered on the gingiva. Definitive diagnosis can only be made by
histopathologic examination of biopsied tissue. The treatment of this lesion is
surgical excision. If surgical excision removal is incomplete, the lesion has
got the risk of the recurrence.
A twelve years old female child applied to our clinic with complaints
like on anterior palatinal region gingival bleeding and swollen condition on
the same region. As beginning treatment oral hygiene education was given to the
patient and plaque and calculus were removed. Under local anesthesia the lesion
was taken with excisional biopsy for doing distinctive diagnosis from the other
pathological lesions which can be seen in oral cavity. In addition frenectomy
surgery in the maxilla and ridge augmentation operation in the mandible is
performed to provide more comfortable oral hygiene. Three-month follow-up
results of the patients were found to occur again in the region of the palatal
gingival enlargement. As a result, it was decided to re-operations performed
gingivectomy. Patient after operations carried out gingivectomy was called to
the appointment checked and encourage oral hygiene.
Conclusion: After taking of the excisional biopsy, the diagnose
was made shaping “The Pyogenic Granuloma” to the mass which was examined
histopathologically under the light microscope. In the control inspection,
there was not any recurrence clinically.
Keywords: Pyogenic granuloma, excisional biopsy.
Anahtar Kelimeler
Kaynakça
- 1. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167–75.
- 2. Ramirez. K, Bruce G, Carpenter W. Pyogenic granuloma: case report in a 9-year-old girl. General Dentistry. 2002;50 (3):280-81.
- 3. Hullihen SP. Case of aneurism by anastomosis of the superior maxillae. Am J Dent Sci 1844;4:160‑2.
- 4. Yaan K, Jin YT, Lin MT. Expression of Tie2, angiopoietin-1, angiopoietin-2, ephrin B2 and Eph B4 in pyogenic granuloma of human gingival implicates their role in inflammatory angiogenesis. J Periodontal Res 2001; 35: 165.
- 5. Angelopulos AP. Pyogenic granuloma of the oral cavity: Statistical Analysis of its clinical features. J Oral Surg 1971; 29: 890.
- 6. Lever VF, Lever GS. Histopathology of the skin. 13. Lpincolt Co, 1990: 698.
- 7. Neville BW, Damm DD, Allen CM, et al. Oral & maxillofacial pathology. 2nd edn. Philadelphia: WB Saunders, 2002:437–95.
- 8. Eversole LR. Clinical outline of oral pathology: diagnosis and treatment. 3rd edn. Hamilton: BC Decker, 2002:113–14.
- 9. Aguilo L. Pyogenic granuloma subsequent to injury of primary tooth: a case report. Int J Paed Dent 2002;12:438–41.
- 10. Shenoy SS, Dinkar AD. Pyogenic granuloma associated with bone loss in an eight-year-old child: a case report. J Indian Soc Pedod Prev Dent 2006;24:201–3.
- 11. Bhaskar SN, Jacoway JR. Pyogenic granulom: clinical features, incidence, histology, and result of treatment: report of 242 cases. J Oral Surg 1966; 245: 391-8.
- 12. Al-Khateeb T, Ababneh K. Oral pyogenic granuloma in Jordanians: a retrospective analysis of 108 cases. J Oral Maxillofac Surg 2003;61:1285-8.
- 13. Regezi JA, Sciubba JJ, Jordan RC. Oral Pathology: Clinical Pathological Considerations. 4th ed. Philadelphia: WB Saunders; 2003. p. 115‑6.
- 14. Gordón-Núñez MA, de Vasconcelos Carvalho M, Benevenuto TG, Lopes MF, Silva LM, Galvão HC. Oral pyogenic granuloma: a retrospective analysis of 293 cases in a Brazilian population. J Oral Maxillofac Surg 2010;68:2185-8.
- 15. Jafarzadeh H, Sanatkhani M, Moshtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167–75.
- 16. Sills ES,Zegarelli DJ, Hoschander MM, Strider WE. Clinical diagnosis and management of hormonally responsive oral pregnancy tumor (pyogenic granuloma). J Reprod Med 1996;41:467-70.
- 17. Fowler EB, Cuenin MF, Thompson SH, Kudryk VL, Billman MA. Pyogenic granuloma associated with guided tissue regeneration: a case report. J Periodontol 1996; 67: 1011-5.
- 18. Wandera A, Walker PO. Bilateral pyogenic granuloma of the tongue in graft-versus-host disease: report of case. ASDC J Dent Child 1994; 61: 401-3.
- 19. Anderson WAD, Scatti MT. Skin. In Synopsiss of Pathology. Cv Mosby Co. 1980: 681.
- 20. Davies MG, Marks R. Dermo-epidermal relationships in pyogenic granulomata. Br J Dermatol 1978; 99: 503-12.
- 21. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006; 48(4): 167-75.
- 22. Mathur LK, Bhalodi AP, Manohar B, Bhatia A, Rai N, Mathur A. Focal fibrous hyperplasia: a case report. Int J Dent Clin 2010; 2(4):6-7.
- 23. Kerr DA. Granuloma pyogenicum. Oral Surg Oral Med Oral Pathol 1951; 42: 158.
- 24. Ramirez. K, Bruce G, Carpenter W. Pyogenic granuloma: case report in a 9-year-old girl. General Dentistry. 2002;50:280-81.
- 25. Karthikeya P, Mahima VG, Lahari K. Exragingival pyogenic granuloma. Indian J Dent Res. 2006;17:199-202.
- 26. Graham RM. Pyogenic granuloma: an unusual presentation. Dent Update. 1996;23:240-41.
- 27. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006;48:167-75.
- 28. Greenberg MS, Glick M. Burket’s oral medicine: diagnosis and treatment. 10th edn. Hamilton: BC Decker, 2003:141–2.
- 29. Ichimiya M, Yoshikawa Y, Hamamoto Y, et al. Successful treatment of pyogenic granuloma with injection of absolute ethanol. J Dermatol 2004;31:342–4.
- 30. Moon SE, Hwang EJ, Cho KH. Treatment of pyogenic granuloma by sodium tetradecyl sulfate sclerotherapy. Arch Dermatol 2005;141:644–6.
- 31. Patrice SJ, Wiss K, Mulliken JB. Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. Pediatr Dermatol 1991, 8: 267-276
- 32. Tay Y-K, Weston WL, Morelli JG. Treatment of pyogenic granuloma in children with the flashlamp-pumped pulsed dye lazer. Pediatrics 1997;99:368-70.
- 33. Pagliai KA, Cohen BA. Pyogenic granuloma in children. Pediatr Dermatol 2004, 21: 10-3.
- 34. Lee CT, Tham SN, Tan T. ›n›t›al experience with CO2 laser in treating dermatological conditions. Ann Acad Med Singapore 1987;16: 713-5.
- 35. Krishnapillai R, Punnoose K, Angadi PV, Koneru A. Oral pyogenic granuloma-a review of 215 cases in a South Indian Teaching Hospital, Karnataka, over a period of 20 years. Oral Maxillofac Surg 2012;16:305-9.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Case Reports |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ağustos 2017 |
| Gönderilme Tarihi | 23 Ekim 2017 |
| Yayımlandığı Sayı | Yıl 2017Cilt: 20 Sayı: 2 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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