Multifactorial etiology of oral pyogenic granuloma: case reports with distinct triggers

Pyogenic granuloma (PG) is a common reactive vascular hyperplasia of the oral cavity with multifactorial origin. Although benign, it shows clinical variability and may recur if predisposing factors persist. This report describes two oral PG cases with different etiologies. A 68-year-old man presented with a mucogingival lesion associated with dental calculus, while a 29-year-old woman developed a lesion during pregnancy that continued after delivery. Both were treated with complete surgical excision and elimination of local irritants. Histopathology confirmed PG, characterized by granulation tissue rich in vascular spaces, inflammatory infiltrate, and areas of epithelial ulceration. Follow-up visits showed good healing and no recurrence. These cases emphasize the interaction of local agents like calculus and biofilm with systemic factors such as gestational hormonal changes. PG management requires identifying contributing factors and performing thorough surgical removal, though alternative methods-cryosurgery, electrosurgery, or laser-may be useful in selected scenarios.