Pathological Characteristics and Management of Gingival Reactive Lesions

Gingival reactive lesions represent a spectrum of non-neoplastic proliferations arising in response to chronic local irritation or trauma. They encompass entities such as focal fibrous hyperplasia, pyogenic granuloma, peripheral ossifying fibroma and peripheral giant cell granuloma. Clinically, these lesions often present as exophytic nodules or sessile masses on the gingival margin, varying in colour from pale pink to erythematous red and ranging in size from a few millimetres to several centimetres. Histologically, they share overlapping features of connective tissue proliferation, vascular proliferation, inflammatory cell infiltrate and, in some cases, mineralised components. Accurate diagnosis relies on correlation of clinical presentation with microscopic examination, with particular attention to the nature and distribution of fibrous stroma, vascular channels and calcified elements. Management centres on conservative surgical excision down to the periosteum, coupled with elimination or control of local irritants such as plaque, calculus and faulty restorations. Regular supportive periodontal therapy and rigorous oral hygiene are pivotal in minimising recurrence, which can be influenced by lesion subtype, patient age and underlying periodontal health. Global research efforts are increasingly focused on refining diagnostic criteria, clarifying pathogenesis and optimising long-term outcomes through adjunctive therapy and targeted follow-up protocols.

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Pathological Characteristics and Management of Gingival Reactive Lesions publication trend

The graph below shows the total number of articles in pathological characteristics and management of gingival reactive lesions across all publications each year (not limited to Nature Index journals).

Technical terms

Reactive hyperplasia: A non-neoplastic overgrowth of tissue in response to chronic irritation or injury.

Epulis: A general term for any gingival mass that originates from the periodontal tissues.

Focal fibrous hyperplasia: A benign connective tissue proliferation characterised by dense fibrous stroma and minimal vascularity.

Pyogenic granuloma: A capillary-rich lesion presenting as a friable, red vascular growth prone to bleeding.

Peripheral ossifying fibroma: A gingival lesion containing fibrous tissue with dystrophic calcification, immature bone or cementum-like deposits.

Peripheral giant cell granuloma: A lesion composed of multinucleated giant cells within a vascular stroma, often associated with haemorrhage.

References

1. A large-cohort study of 2971 cases of epulis: focusing on risk factors associated with recurrence. BMC Oral Health (2023).
2. Peripheral ossifying fibroma: A 20-year retrospective study with focus on clinical and morphological features. Medicina Oral Patología Oral y Cirugia Bucal (2022).
3. Atypical Peripheral Ossifying Fibroma of the Mandible. Dentistry Journal (2022).