{"id":19568,"date":"2018-03-25T11:40:08","date_gmt":"2018-03-25T11:40:08","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=19568"},"modified":"2020-04-23T04:41:10","modified_gmt":"2020-04-23T04:41:10","slug":"prevalence-and-distribution-of-gingival-pyogenic-granuloma-in-sulaimani-population-kurdistan-region-iraq","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol11no1\/prevalence-and-distribution-of-gingival-pyogenic-granuloma-in-sulaimani-population-kurdistan-region-iraq\/","title":{"rendered":"Prevalence and Distribution of Gingival Pyogenic Granuloma in Sulaimani population – Kurdistan Region – Iraq"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

Pyogenic granuloma (\u201cGranuloma gravidarum\u201d, \u201cpregnancy tumor\u201d) is nonmalignant lesion that affect skin and mucosa ,which may occur inside or outside the oral cavity.1<\/sup>\u00a0 The accurate\u00a0 etiology and pathogenesis of pyogenic granuloma (PG) is still not obvious although, many researchers mentioned that pyogenic granuloma occurred due to\u00a0 an intensive reaction of localized connective tissue to a little irritating factor.2<\/sup>\u00a0Many etiological factors for pyogenic granuloma have been reported for instance, primary teeth exfoliation, eruption \u00a0of\u00a0 adult teeth ,traumatic factors, hormonal change, gingival\u00a0 inflammation, chronic irritant factor, medications, vascular lesions, defective restoration, food accumulation or strange object and calculus in the gingiva and poor oral hygiene status.3,4,5<\/sup><\/p>\n

Sometime pyogenic granuloma (PG) inside the oral cavity is associated with pregnancy.5<\/sup>\u00a0gingival pyogenic granuloma (GPG) occurs up to 5 percent \u00a0of pregnancies,6<\/sup>\u00a0however, bacterial plaque and infection of gingiva are essential for hormonal alteration which result in gingivitis.7<\/sup><\/p>\n

Oral pyogenic granulomas shows tendency for the gingiva, 75 percent of the cases of pyogenic granulomas may occur in the gingiva,8<\/sup>\u00a0but it may be also located in the oral mucosa, lips, palate and tongue5<\/sup>. It is painful\u201d pedunculated\u201d, \u201csessile\u201d, \u201cresilient\u201d, \u201cexophytic\u201d, \u201cnodule\u00a0 or papule\u201d with more than one lobe or smooth surface that bleed easily, it has more tendency to females 5<\/sup>. Pyogenic granuloma may be found in any age, though it is commonly seen in young females (20-30 years), this may be due to the hormonal alterations in this period9<\/sup>. The color of pyogenic granuloma may vary from pink to red or purple.10\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/sup><\/p>\n

Diagnosis of pyogenic granuloma (PG)\u00a0 depend on clinical, Histopathological and\u00a0 Radiographical\u00a0 examinations. \u201cperipheral giant cell granuloma\u201d, \u201chyperplastic gingival\u00a0 inflammation\u201d, \u201cKaposi’s\u00a0 sarcoma\u201d \u201cperipheral odontogenic fibroma\u201d, \u201cperipheral ossifying fibroma\u201d, \u201cangiosarcoma\u201d and \u201chemangioma\u201d should be consider in differential diagnosis of pyogenic\u00a0 granuloma.11<\/sup>\u00a0Surgical excision which combined with removal of irritant local factors is the treatment of pyogenic granuloma.5\u00a0<\/sup>Pyogenic granuloma is associated with recurrence rates which ranged (from 0- to 16) percent. 5,12<\/sup><\/p>\n

This study was performed in order to determine the prevalence of gingival pyogenic granuloma (GPG) in Sulaimani city population -Kurdistan region-Iraq; to find its \u2019percent in maxilla and mandibula and to detect if there is any correlation between gingival pyogenic granuloma (GPG) and (systemic diseases and oral hygiene status).<\/p>\n

Materials and Methods<\/strong><\/p>\n

The total stratified sample of the studied population was comprised of [1136 (568 male +568 female)]\u00a0and the randomly selected sample include [248 (124 male and 124 Female), aged (from\u00a0 10 to 70 year). The subjects were recruited from patients attending to college of Dentistry – Sulaimani university. Disposable dental mirrors and\u201d Williams\u201d graduated periodontal probes (Marking at 1, 2,3,5,7,8,9,10 mm) were used for oral inspection of gingival pyogenic granuloma and determination of oral hygiene condition (poor ,fair, good). The pregnant sample was divided according to the trimesters into 3 subgroups: Subgroup 1: includes women at First trimester; Subgroup 2: includes women at Second trimester; Subgroup 3 includes women at Third trimester.<\/p>\n

A questionnaire was taken from all sample including their names, ages, sex, marital status, medical history and history of presence and duration of\u00a0 gingival pyogenic granuloma, pregnancy trimester and number of deliveries. This research was approved by the ethical committee from medical Factuality\u2013Sulaimani University. However, these patients were not included in the study : Edentulous patients and those taking immunosuppressives, anticonvulsants or calcium channel blockers.<\/p>\n

The Histopathological\u00a0 test was done in Oral Pathology branch – College of Dentistry \u2013 Medical Factuality \u2013Sulaimani University . SPSS version 19 was used to analyzed data .Associations between gingival pyogenic granuloma (GPG) and different variables was tested by using Chi-square test. Non-significant \u00a0P > 0.05, Significant 0.05 \u2265 P > 0.01, highly significant P \u2264 0.0.<\/p>\n

Results<\/strong><\/p>\n

The percent of females group was (49.2 %), male group was (50.2%); male and female (10-20 years) and (40-50 years) was (17.4%); (21-30 years) and (31-40 years) age groups were (24.3%) and (23.1%) respectively. (51-60 years) and (61-70 years) the percent were (9.7%) and (8.1%) respectively as shown in table (1).<\/p>\n

The percent of the total sample with gingival pyogenic granuloma was (11.3%). The percent of patients with history of gingival pyogenic granuloma (GPG) was (2.8%). Most of patients with (GPG) was in female age group (21-30 year). Regarding the oral hygiene status\u00a0 the percent of poor oral hygiene was (45.3%), fair (49.4%) and good (5.3%)\u00a0 as shown in table (2).<\/p>\n

In terms of systemic condition\u00a0 the percent of patients with systemic diseases was (22.7%).; hypertension was (7.3%); Type II diabetes mellitus (4.5 %) ; renal stone (1.6 %); cardiac disease ,stomach ulcer, backache, and migraine were (1.2%); Thyrotoxicosis, irritable colon and stone in gallbladder ( 0.8%); Type I diabetes mellitus, hypoglycemia, rheumatism, hypotension, psychological (0.4 %) as shown in table (3). The percent of married patients was (66%). The percentage of patients with\u00a0 first trimester of\u00a0 pregnancy was (1.2 %), third trimester was (0.8%) as\u00a0 shown in table (4). The percent of gingival pyogenic granuloma in buccal gingiva between right upper central and lateral incisors, buccal gingiva between maxillary right lateral incisor and canine, buccal gingiva between right lower canine and lateral incisor were (1.2%). The percent of gingival pyogenic granuloma in buccal gingiva between left central, lateral incisors and canine in mandible, buccal gingiva between mandibular left and right central incisors were (0.8%). The percent of gingival pyogenic granuloma in buccal gingiva between lower left lateral incisor and canine \u00a0was (0.6%). The percentage of gingival pyogenic granuloma in buccal gingiva between lower right First and Second molars; buccal\u00a0 gingiva between upper right and left central incisors; buccal\u00a0 gingiva between upper left central and lateral incisors; buccal gingiva of upper right lateral incisor; buccal gingiva between upper right First and Second premolars; palatal gingiva between upper left\u00a0 lateral incisor and canine; buccal gingiva between lower right central, lateral incisor and canine; buccal gingiva between upper left canine and First premolar; palatal gingiva between upper right lateral incisor and canine; palatal gingiva between upper left central and lateral incisors was (0.4%) as shown in table (5).<\/p>\n

The percent\u00a0 of duration of gingival pyogenic granuloma of one month was (1.6%); two month (2.8%); three months (1.6%), four and six and 12 months (1.2%), 24 months (0.8%), eight and 36 months (0.4%) as shown in table (6).<\/p>\n

A highly significant correlation was found between gingival pyogenic granuloma (GPG) and history of (GPG). There was significant relationship between gingival pyogenic granuloma and (oral hygiene status; and systemic condition). While there were\u00a0 no significant correlation between gingival pyogenic granuloma (GPG) and (age groups; Pregnancy complications; type of systemic disease; marital status; pregnancy trimester; number of boys; number of girls) as shown in table (7).<\/p>\n

Table 1: frequency and percent of gingival pyogenic granuloma according to age group<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\n\u00a0<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Gender<\/strong><\/td>\nTotal males<\/td>\n124<\/td>\n50.2<\/td>\n<\/tr>\n
Total Females<\/td>\n123<\/td>\n49.2<\/td>\n<\/tr>\n
Male and female in each age group (Years)<\/strong><\/td>\n10-20<\/td>\n43<\/td>\n17.4<\/td>\n<\/tr>\n
21-30<\/td>\n60<\/td>\n24.3<\/td>\n<\/tr>\n
31-40<\/td>\n57<\/td>\n23.1<\/td>\n<\/tr>\n
41-50<\/td>\n43<\/td>\n17.4<\/td>\n<\/tr>\n
51-60<\/td>\n24<\/td>\n9.7<\/td>\n<\/tr>\n
61-70<\/td>\n20<\/td>\n8.1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 2: frequency and percent of gingival pyogenic granuloma in total sample, pregnancy complication, history of gingival pyogenic granuloma and oral hygiene status<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\n\u00a0<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Gingival pyogenic granuloma(GPG)<\/td>\nNo GPG<\/td>\n219<\/td>\n88.7<\/td>\n<\/tr>\n
GPG<\/td>\n28<\/td>\n11.3<\/td>\n<\/tr>\n
Pregnancy complications(PC)<\/td>\nNO PC<\/td>\n228<\/td>\n92.3<\/td>\n<\/tr>\n
Abortion<\/td>\n15<\/td>\n6.1<\/td>\n<\/tr>\n
Low term birth<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Preterm birth<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
History of Gingival pyogenic granuloma(GPG)<\/td>\nNo history of(GPG)<\/td>\n240<\/td>\n97.2<\/td>\n<\/tr>\n
History of (GPG)<\/td>\n7<\/td>\n2.8<\/td>\n<\/tr>\n
Oral hygiene status<\/td>\nPoor<\/td>\n112<\/td>\n45.3<\/td>\n<\/tr>\n
Fair<\/td>\n122<\/td>\n49.4<\/td>\n<\/tr>\n
Good<\/td>\n13<\/td>\n5.3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 3: Frequency and percent of systemic diseases<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\n\u00a0<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Systemic condition<\/strong><\/td>\nNo\u00a0 systemic diseases<\/td>\n190<\/td>\n77.3<\/td>\n<\/tr>\n
With systemic diseases<\/td>\n57<\/td>\n22.7<\/td>\n<\/tr>\n
Type of systemic diseases<\/strong><\/td>\nType I diabetes mellitus<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Type II diabetes mellitus<\/td>\n11<\/td>\n4.5<\/td>\n<\/tr>\n
Hypoglycemia<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Hypertension<\/td>\n18<\/td>\n7.3<\/td>\n<\/tr>\n
cardiac disease<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Thyrotoxicosis<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n
Irritable colon<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n
Stomach ulcer<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Migraine<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Renal stone<\/td>\n10<\/td>\n1.6<\/td>\n<\/tr>\n
Stone in gallbladder<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n
Rheumatism<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Backache<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 4: frequency and percent of material status, pregnancy trimester<\/strong><\/p>\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Material status Unmarried<\/td>\n84<\/td>\n34.0<\/td>\n<\/tr>\n
Married<\/td>\n163<\/td>\n66.0<\/td>\n<\/tr>\n
non-pregnant<\/td>\n242<\/td>\n98.0<\/td>\n<\/tr>\n
pregnant\u00a0 first trimester<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
\u00a0pregnant third trimester<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 5: Frequency and percent of the sits of distribution of gingival pyogenic granuloma<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\n\u00a0<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Sites\u00a0 of pyogenic granuloma <\/strong><\/td>\nBuccal gingiva between lower right First and Second molars<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva between lower left lateral incisor and\u00a0\u00a0 canine<\/td>\n4<\/td>\n0.6<\/td>\n<\/tr>\n
Buccal\u00a0 gingiva between upper right & left central incisors<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva between maxillary left lateral \u00a0& central incisors<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva between \u00a0left\u00a0 mandibular central\u00a0 & lateral incisors & canine<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n
Buccal\u00a0 gingiva between\u00a0\u00a0 maxillary \u00a0right central & lateral incisors<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Buccal gingiva of right \u00a0maxillary lateral incisor<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva\u00a0 between upper right First and Second premolars<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Palatal\u00a0 gingiva between upper left\u00a0 lateral incisor and canine<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva\u00a0\u00a0 between lower right and left central incisors<\/td>\n2<\/td>\n0.8<\/td>\n<\/tr>\n
Buccal gingiva between upper\u00a0 right lateral incisor and canine<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Buccal gingiva between\u00a0 lower right central and lateral incisor s and canine<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal gingiva between upper left canine and First premolar<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Buccal\u00a0\u00a0 gingiva between\u00a0 lower right lateral incisor s and canine<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
Palatal\u00a0\u00a0 gingiva between upper right lateral incisor s and canine<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
Palatal\u00a0\u00a0 gingiva between upper left central and lateral incisors<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 6: Duration of gingival pyogenic granuloma<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\n\u00a0<\/strong><\/td>\nfrequency<\/strong><\/td>\nPercent<\/strong><\/td>\n<\/tr>\n
Duration of Gingival pyogenic granuloma<\/strong><\/td>\n1 month<\/td>\n4<\/td>\n1.6<\/td>\n<\/tr>\n
2 month<\/td>\n7<\/td>\n2.8<\/td>\n<\/tr>\n
3Months<\/td>\n4<\/td>\n1.6<\/td>\n<\/tr>\n
4 months<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
6 months<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
8 months<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n
12months<\/td>\n3<\/td>\n1.2<\/td>\n<\/tr>\n
36 months<\/td>\n1<\/td>\n0.4<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 7: (Chi-square) correlation between Gingival pyogenic granuloma and variables<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Gingival pyogenic granuloma(GPG)<\/strong><\/td>\nVariables<\/strong><\/td>\nChi-square<\/strong><\/td>\n<\/tr>\n
<\/td>\nAge groups<\/td>\n0.47<\/td>\n<\/tr>\n
GPG<\/td>\nPregnancy complications<\/td>\n0.452<\/td>\n<\/tr>\n
GPG<\/td>\nHistory of GPG<\/td>\n0.000<\/td>\n<\/tr>\n
GPG<\/td>\nOral hygiene status<\/td>\n0.006<\/td>\n<\/tr>\n
GPG<\/td>\nSystemic condition<\/td>\n0.037<\/td>\n<\/tr>\n
GPG<\/td>\nType of systemic disease<\/td>\n0.898<\/td>\n<\/tr>\n
GPG<\/td>\nmarital status<\/td>\n0.058<\/td>\n<\/tr>\n
GPG<\/td>\npregnant trimester<\/td>\n0.722<\/td>\n<\/tr>\n
GPG<\/td>\nNumber of boys<\/td>\n0.733<\/td>\n<\/tr>\n
GPG<\/td>\nNumber of girls<\/td>\n0.277<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Discussion<\/strong><\/p>\n

In this study the percent of patients with gingival pyogenic granuloma (GPG) was (11.3%) , while\u00a0 other studies found it \u00a0(35%),13<\/sup>\u00a0 (49.2%)14<\/sup> and (57%).15<\/sup>\u00a0These variations between researches may be due to the \u00a0\u00a0differences\u00a0 \u00a0in design and performance of the studies.<\/p>\n

The result of this study showed that gingival pyogenic granuloma could be develop in all age but , the most of patients with (GPG) were females in \u00a0age group (21-30 year), this because \u00a0\u00a0of rising \u00a0in\u00a0 estrogen\u201d and \u201cprogesterone\u201d. This\u00a0 result was \u00a0in agreement with,10,12,16\u00a0<\/sup>they found that \u00a0although (GPG) may develops in all ages, but they were more commonly appeared in females age group (21-30 year). Hormonal change lead to physiological \u00a0alteration \u00a0in gingival tissue, which contain \u00a0\u201csteroid hormones\u201d receptors, that \u00a0could increase the reaction of\u00a0 tissue to irritating factors and alter the \u201cmicrobiota\u201d and lead to more\u00a0 predominance\u00a0 of pathogenic bacteria. However, other study \u00a0\u00a0demonstrated \u00a0\u00a0that there was no effect of female hormones on oral pyogenic granulomas, because they found that pyogenic granuloma occurred in both males and females without gender preference.<\/p>\n

While the result of this study was in disagreement\u00a0\u00a0 with16<\/sup> who \u00a0\u00a0found that Pyogenic granulomas occur in all age groups, but they\u00a0 were common in \u00a0age group (10-20 year). This study was inconsistent with15<\/sup>; they mentioned \u00a0\u00a0that pyogenic granuloma was periodomently \u00a0found in\u00a0\u00a0\u00a0 second decade of males , this because of the impact of elevation of sex hormones to \u00a0the maximum level\u00a0\u00a0 with obvious poor oral hygiene in\u00a0 male in this age. This\u00a0\u00a0 lead \u00a0\u00a0to initiate excessive increase in size of gingiva in presence of irritating factor for example, plaque and calculus.<\/p>\n

Pyogenic granuloma develops up to 5 percent in pregnancy. The presence of this lesion in pregnancy suggests the possible correlation \u00a0\u00a0between gingival lesions and the hormonal status during this period.18<\/sup>There were some changes occur in women during pregnancy \u00a0\u00a0such as, food habits and frequency \u00a0of meal take, oral hygiene is affected\u00a0 due to nausea and sleepless.9<\/sup>\u00a0The raise in prevalence of PG in the third trimester and the tendency to reduction in size after delivery indicate a clear hormonal association in the etiology of pyogenic granuloma.14<\/sup><\/p>\n

This \u00a0\u00a0study was agreed with the findings of,13,14<\/sup>\u00a0they showed that pyogenic granuloma had maxillary predominance. In addition this study was in agreement with19<\/sup> who found that the gingiva was the most common affected site \u00a0\u00a0and the maxilla more affected than mandible .While this\u00a0\u00a0 study was\u00a0\u00a0 in disagreement with20<\/sup> who revealed that GPG were slightly more commonly found \u00a0on the buccal mandibular gingival region of .<\/p>\n

This study demonstrated that frontal regions of maxillary and mandibular gingiva are more frequently affected than posterior areas\u00a0 \u00a0and most of GPG were showed on the gingival margin, this result was in agreement with,21<\/sup>\u00a0they noticed similar findings.<\/p>\n

Conclusions\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/strong><\/p>\n

This study showed that the percentage of the total sample with gingival pyogenic granuloma was (11.3%). Although pyogenic granuloma (GPG) may occurs at any age ,\u00a0 the most of patients with GPG was in females\u00a0 age group (21-30 year).\u00a0 In addition, the high percentage of gingival pyogenic granuloma was\u00a0 found\u00a0 in\u00a0 maxillary buccal\u00a0 gingiva . Moreover, there was highly significant correlation between gingival pyogenic granuloma (GPG) and history of (GPG) .Furthermore, there was significant correlation between gingival pyogenic granuloma and( oral hygiene status and systemic condition). While there were\u00a0 no significant correlation between gingival pyogenic granuloma (GPG) and\u00a0 (age groups, pregnancy complications, type of systemic disease ,marital status ,pregnancy trimester and number of kids).<\/p>\n

Acknowledgements<\/strong><\/p>\n

We are thankful to staff of Periodontics Department, College of Dentistry, Sulaimani University for their valuable help and made the success of this study. In addition, a great thanks and warmth appreciation to the patients for their participation in this research.<\/p>\n

Conflict of interest<\/strong><\/p>\n

There is no conflict of interest.<\/p>\n

References<\/strong><\/p>\n

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