Management of pyogenic granuloma mimicking a tooth: A case report

Pyogenic granuloma gravidarum is a benign, pregnancy-associated, reactive vascular lesion of the gingiva with a marked tendency to bleed. Surgical management can be challenging because of its high vascularity, especially in pregnant patients. A 37-year-old woman in her second trimester of pregnancy presented with a rapidly enlarging, bleeding, tooth-like gingival mass in the left maxillary posterior region that interfered with mastication and oral hygiene. Clinical and radiographic evaluations suggested a reactive gingival lesion. The lesion was excised using a 445 nm visible blue diode laser under local anesthesia. Histopathological examination confirmed the diagnosis of a pyogenic granuloma. Laser excision provided excellent intraoperative hemostasis, eliminated the need for sutures, and resulted in minimal postoperative discomfort. Healing was uneventful, with complete epithelialization within one week and no recurrence during the follow-up period. Excision of pyogenic granuloma gravidarum using a 445 nm visible blue diode laser achieved precise tissue removal, effective hemostasis, and favorable healing without the need for sutures. This technique may offer advantages in managing highly vascular lesions during pregnancy.