Exacerbated Oral Pyogenic Granuloma in Type 2 Diabetes Mellitus and Advanced Periodontitis: Clinical Management and Pathophysiological Insights: A Case Report Publisher



Alcaraz Baturoni F J ; Ibarra Gonzalez J P ; Lopez Hernandez L F ; Alarcon Sanchez M A ; Ortuno Sahagun D ; Heboyan A ; Gonzalez Cardenas J P ; Lomeli Martinez S M
Source: Journal of Surgical Case Reports Published:2026

Abstract

Oral pyogenic granuloma (OPG) is a benign vascular proliferation that presents as a solitary, pedunculated, or sessile lesion, associated with irritative factors. Various systemic disorders, particularly type 2 diabetes mellitus (DM2), may contribute to its onset and progression through inflammatory and endothelial mechanisms. This clinical case report describes a 63-year-old male with a history of controlled hypertension and DM2 with glycated hemoglobin (HbA1c) of 7.97%, diagnosed with stage III, grade C generalized periodontitis. Therapeutic management began with periodontal phase I, including personalized oral hygiene instructions and scaling and root planning. After re-evaluation at 5 weeks, an excisional biopsy of the hyperplastic lesion was performed. Histopathological analysis confirmed OPG. The postoperative course was favorable, with proper healing at 15 days. Recent studies indicate that T2DM exacerbates periodontal inflammation through advanced glycation end-products and receptor for advanced glycation end-products (RAGE) signaling, accelerating OPG progression. Multidisciplinary approaches, including glycemic optimization, improve outcomes in these comorbidities. © The Author(s) 2026. Published by Oxford University Press and JSCR Publishing Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.