Peripheral giant cell granuloma associated with dental prostheses: A case report

Table 1 Local factors relevant to peripheral giant cell granuloma

Category	Examples	Clinical relevance
Biofilm-related factors	Plaque, calculus, food impaction	Sustain chronic gingival inflammation
Prosthetic/restorative factors	Overhanging margins, poor marginal adaptation, rough surfaces, defective pontic design, poor emergence profile	Increase plaque retention and/or soft tissue trauma
Periodontal factors	Chronic periodontitis, deep inflammation around abutment teeth	May contribute to a reactive gingival environment
Traumatic factors	Repetitive mechanical irritation, impinging prosthetic components	Promote persistent local injury
Systemic/contextual contributors	Hormonal changes, xerostomia, impaired hygiene access	May increase susceptibility, though usually not sufficient alone

Table 2 Diagnostic considerations in gingival nodular lesions

Lesion	Typical clinical clues	Role of histopathology
Peripheral giant cell granuloma	Red-purple gingival/alveolar ridge nodule; may ulcerate; reactive setting	Confirms multinucleated giant cells in vascular stroma with hemorrhage/hemosiderin
Pyogenic granuloma	Soft, highly vascular, bleeds easily	Distinguishes capillary granulation tissue pattern from PGCG
Peripheral ossifying fibroma	Firmer, often paler, gingival mass	Demonstrates fibrous proliferation with mineralized material
Fibroma	Firm, mucosal-colored nodule	Shows dense fibrous connective tissue
Brown tumor of hyperparathyroidism	Giant cell lesion pattern with systemic metabolic context	Requires clinicopathologic and biochemical correlation
Plasma cell gingivitis	Diffuse erythematous/plasma cell-rich gingival changes	Histology and, if needed, adjunctive workup aid exclusion of mimics
Hematologic/neoplastic lesions (e.g., plasmacytoma, leukemia-related enlargement)	Atypical appearance, systemic signs, rapid progression, or unusual site/course	Biopsy is essential; immunohistochemistry may be required

PGCG: Peripheral giant cell granuloma.

Table 3 Timeline of clinical events and follow-up

Time point	Event
Day 0	Initial clinical assessment; lesion identified beneath the defective FDP; periapical radiographs obtained; FDP removed; complete excision with curettage performed; non-restorable tooth #22 extracted during the same procedure
Day 20	Suture removal; favorable healing observed; transitional acrylic removable partial denture delivered
6 months	No clinical recurrence; continued maintenance and definitive prosthetic planning

FDP: Fixed dental prosthesis.