Recurrent pyogenic granuloma treatment by feeder vessel cauterization with high power diode laser

Pyogenic granuloma is a traumatic lesion that affects the mucocutaneous tissues of oral cavity. It is more prevalent in gingival tissues and in young women. The purpose of this report is to present an atypical case where anatomical features, detectable only by complementary exams, implied on the recurrence of the lesion. A 21-year-old caucasian female presented a recurrent oral pyogenic granuloma after two excisional biopsies and curettage of the periosteum. A cone beam computed tomography revealed a feeder vessel in an intraseptal centered position, up to the base of the lesion. Therefore, the third surgery included the vessel cauterization with a high power diode laser. After one year of the third surgery, no recurrence was noted. This case reinforces the use of imaging exams to investigate the presence of intraosseous vascular networks associated to recurrent pyogenic granuloma, principally on the absence of significant local irritants, such as trauma and calculus, or systemic changes. After lesion removal, the cauterization of the feeding vessel with a high power laser is an efficient approach.