Exacerbated oral pyogenic granuloma in type 2 diabetes mellitus and advanced periodontitis: clinical management and pathophysiological insights: a case report.

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.