{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:01:02Z","timestamp":1774317662386,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Oral pyogenic granulomas (PGs) presenting in association with dental implants are uncommon occurrences. While tooth\u2010associated PGs are well\u2010documented in the literature, there are only seven case reports with biopsy\u2010confirmed diagnoses of PG related to dental implants. This case report details the treatment of an intraoral PG related to dental implants that had been osseointegrated and asymptomatic for 10 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 39\u2010year\u2010old female presented with a hyperplastic erythematous mass that encompassed the dental implants in the position of the maxillary central incisors. Surgical exploration of the site revealed nonintegrated, particulate bone material distributed throughout the peri\u2010implant tissues approximating the granuloma. Treatment involved surgical excision of the lesion, elimination of all nonintegrated bone material, and implant surface debridement. Laser therapy was later used to manage a recurrence. Histology of the biopsied tissue confirmed the diagnosis of PG and described the presence of multiple exogenous, refractile, particulate materials in the specimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of surgical excision, implant debridement, and conservative laser therapy resulted in the elimination of a dental implant\u2010related PG and successful soft tissue management. The localized presence of nonintegrated particulate bone material surrounding the granuloma appears to have functioned as a chronic irritant to the peri\u2010implant soft tissues over time and is likely, along with oral bacteria, the primary etiological agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key points<\/jats:title><jats:p>Why is this case new information?\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>There is a paucity of reports describing the management of dental implant\u2010related pyogenic granulomas especially in the esthetic region. The present case demonstrates that particulate bone materials used in guided bone regeneration have the capacity to behave as a low\u2010grade irritant to the gingival tissues. It also demonstrates the successful elimination of the tissues and management of the peri\u2010implant soft tissues for an esthetic result.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><jats:p>What are the keys to successful management of this case?\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The key to successful management of this case was adequate removal of the exogenous irritant, proper implant surface debridement, and decontamination and adequate gingivoplasty to remove all residual hyperplastic granulomatous tissues. Additionally, patient education and appropriate oral hygiene instructions were important to proper healing and maintenance of the area.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><jats:p>What are the primary limitations to success in this case?\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The ambiguity of the clinical boundaries of PGs makes it challenging to guarantee complete excision beyond the base of the lesion, leading to recurrence.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/cap.10219","type":"journal-article","created":{"date-parts":[[2022,7,31]],"date-time":"2022-07-31T13:24:37Z","timestamp":1659273877000},"page":"50-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The management of an oral pyogenic granuloma around osseointegrated dental implants"],"prefix":"10.1002","volume":"13","author":[{"given":"Danielle K.","family":"Burgess","sequence":"first","affiliation":[{"name":"Division of Periodontology Department of Oral Medicine, Infection and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Paul A.","family":"Levi","sequence":"additional","affiliation":[{"name":"Division of Periodontology Department of Oral Medicine, Infection and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Periodontology Department of Oral Medicine, Infection and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Clinical Outline of Oral Pathology: Diagnosis and 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