Peripheral Giant Cell Granuloma Associated With Severe Periodontal Destruction in the Esthetic Region: A Case Report.

Peripheral giant cell granuloma (PGCG) is a reactive lesion typically confined to the gingiva or alveolar mucosa and is generally regarded as a soft tissue entity. Although superficial bone involvement has occasionally been described, extensive periodontal destruction is not consistently observed. This report describes a case of PGCG occurring in the maxillary anterior region in association with advanced periodontal bone loss. A 37-year-old male presented with a progressively enlarging, asymptomatic swelling between Teeth #11 and #12 of 3 months' duration. Clinical examination revealed a pedunculated, purple-red mass measuring approximately 14 × 11 mm. Periodontal assessment demonstrated Stage III, Grade C periodontitis with deep probing depths extending toward the apical third of the roots and Grade III mobility of the involved teeth. Radiographic evaluation showed advanced horizontal bone loss and a pronounced interdental periodontal defect. The lesion was completely excised with adequate margins, and due to extensive periodontal support loss, Teeth #11 and #12 were extracted during the same surgical procedure. Histopathological analysis confirmed the diagnosis of PGCG. Healing was uneventful, and no clinical signs of recurrence were observed at 1-month follow-up. This case highlights that PGCG may coexist with advanced periodontal destruction in natural dentition and emphasizes the importance of comprehensive periodontal evaluation and complete surgical excision to minimize recurrence risk.