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What is peripheral giant cell granuloma?
Peripheral giant cell granuloma is a tumor-like lesion originating in the attached gingiva or in the mucosa of the edentulous alveolar ridge. It is often confused with pyogenic granuloma, a relatively common lesion.
The lesion usually presents as a red and sometimes bluish-red nodular mass. The size is usually less than 2 cm in diameter, but larger and more voluminous lesions may also occur. The base of insertion into the alveolar tissues may be peduncular or sessile and it is not uncommon to find a region of persistent ulceration at one end of the lesion.
Causes of peripheral giant cell granuloma
The final diagnosis is established by histopathological examination.
Giant cell peripheral granuloma usually appears between the fifth and sixth decade of life and predominantly affects women. The most commonly affected area is usually the jaw.
Although the etiology is not yet well defined, clinical studies attribute an important role to the establishment of a chronic inflammatory framework by local irritants, either by the accumulation of dental biofilm, poorly adapted prostheses, repetitive trauma or foreign bodies.
The treatment of choice for peripheral giant cell granuloma is surgical excision and elimination of possible causative factors to avoid recurrence.
Hence the primary role of the dentist and dental hygienist in motivating and instructing the patient in proper oral hygiene, as well as recommending specific devices and products for the "active" phase of treatment and during follow-up.
Symptoms of giant cell granuloma periphericans
The lesion starts deep in the jaw, in the bone marrow tissue, and may develop in about a month. A black or dark purple sore may be seen on the underside of the gums.
Aside from the physical appearance of the oral lesion, a peripheral giant cell granuloma is unlikely to cause any adverse effects. Some patients report tenderness after eating or talking. If the granuloma should develop any ulcerated areas, it may cause pain, swelling and tenderness in the mouth.
A dentist can usually detect a peripheral giant cell granuloma by evaluating the physical appearance. He or she usually asks about any recent trauma to the jaw, previous dental work and the patient's current dental hygiene regimen to determine possible causes.
X-rays are taken to check for damage to the jaw and a small tissue sample may be taken from the lesion for histopathologic study to confirm the diagnosis of peripheral giant cell granuloma.
Treatment of giant cell granuloma peripheralis peripheris
Peripheral giant cell granuloma represents a benign lesion of the oral cavity.
Although surgical excision remains the treatment of choice, the importance of controlling dental biofilm both pre- and post-surgically should not be underestimated, as it is one of the triggering causes of the lesion.
To achieve control of dental biofilm in the oral cavity, one of the recommendations is usually to complement toothbrushing with chlorhexidine and/or cetylpyridinium chloride mouthwashes. The work of the dental hygienist, as a preventive professional, is fundamental in the clinical management of this and other pathologies that may occur in the oral cavity.
