Clinical Report
Management of peripheral giant cell granuloma around complete-arch fixed implant-supported prosthesis: A case series

https://doi.org/10.1016/j.prosdent.2019.02.014Get rights and content

Abstract

Abnormal peri-implant tissue response in the form of benign reactive lesions, such as peripheral giant cell granuloma and pyogenic granuloma, is a less frequent biologic complication associated with dental implant therapy. However, these lesions can cause gingival pain, swelling, and discomfort, as well as peri-implant bone loss and possible implant failure. Few reports in the dental literature have described these lesions around complete-arch fixed implant-supported prostheses. The purpose of this clinical report was to describe 3 distinct scenarios in patients with complete-arch fixed implant-supported prostheses presenting with benign reactive lesions that were histologically diagnosed as peripheral giant cell granulomas. Each of these 3 patients had acrylic resin as one of the materials in their prosthesis. The distinctive management of each of these 3 patients encompassed surgical, prosthodontic, and pharmacologic means.

Section snippets

Patient 1

A 49-year-old African-American man presented to the prosthodontist with benign reactive growth around his left anterior maxillary implant (Fig. 1). The patient's dental history revealed that he had had 6 maxillary implants placed along with bone grafting procedures 10 years before. He had been functioning with a maxillary metal-resin CAFIP with no mechanical or biological complications and had been under routine professional maintenance during the 10-year period. The patient experienced minor

Discussion

The purpose of this clinical case series was to describe the presentation and management of 3 distinct scenarios of PGCG, which is a benign reactive lesion with an unknown definitive etiology. Besides the 2 common benign differential diagnoses (PG and POF) related to PGCG, it is important to rule out peri-implant infections, drug-induced gingival enlargement, allergic reaction to any biomaterials, and oral malignancy presenting in this region.

Not all PGCGs can be managed successfully and simply

Summary

This clinical report described a case series of 3 distinct scenarios in patients with a complete-arch fixed implant-supported prosthesis who presented with benign reactive lesions diagnosed as peripheral giant cell granuloma. One patient was managed by straightforward surgical excision without any subsequent recurrence, whereas the second patient with a recurrence was managed by implant removal and the third by surgical, prosthodontic, and pharmacologic means. To the authors' knowledge, this is

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© 2019 by the Editorial Council for The Journal of Prosthetic Dentistry.