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36 rev port estomatol med dent cir maxilofac . 2026;67(1):34-39

Table 1. Differential diagnosis of a reddish exophytic gingival lesion
Lesion Key clinical features Radiographic findings Histopathology Differentiation from Pgcg
Pyogenic granuloma Soft, bright red, lobulated, No bone involvement Granulation tissue with More vascular, lacks giant
often ulcerated numerous capillaries cells
Peripheral ossifying Firm pink or red nodule, May show focal Fibrous stroma with Firm texture, presence of
fibroma interdental papilla calcifications mineralized tissue calcifications
Peripheral odontogenic Slow-growing, firm lesion No bone involvement Fibrous tissue with No multinucleated giant
fibroma odontogenic rests cells
Hemangioma Bluish-red, compressible, No bone involvement Proliferation of vascular Positive blanching on
blanches on pressure channels diascopy and possible blood
aspiration
Central giant cell Intraosseous origin Radiolucency with cortical Giant-cell–rich stroma Originates within the bone
granuloma thinning
Brown tumor Bone lesion associated with Radiolucent lesion with bone Giant-cell–rich lesion similar Requires correlation with
(hyperparathyroidism) hyperparathyroidism; may involvement to central giant cell systemic metabolic findings
mimic giant cell lesions granuloma (calcium, phosphate, ALP,
PTH)
PGCG, peripheral giant cell granuloma.

affected area; the residual roots were extracted, and scaling
and root planning of adjacent teeth were performed. No de-
fective restorations or prosthetic factors were identified. Peri-
odontal evaluation revealed no significant tooth mobility or
deep periodontal pockets, and all adjacent teeth were pre-
served. This comprehensive approach aimed to eliminate po-
tential sources of chronic irritation and reduce the risk of re-
currence.
Primary closure was achieved using interrupted sutures
with non-resorbable silk (3-0). The excised specimen was fixed

Figure 1. Intraoral view showing a reddish-violet
pedunculated lesion from the permanent mandibular
right canine to the permanent mandibular right
second premolar (teeth 43–45).

Figure 2. Panoramic radiograph showing superficial
cortical alteration in the region of teeth 43–45 and the Figure 3. Gross view of the excised lesion, showing its
presence of residual roots and carious lesions. pedunculated appearance.