History of the present illness

This 66-year-old white male presented to the Department of Periodontology, School of Dentistry complaining of a swelling of one year’s duration associated with an implant in the area of tooth #28 (Figure 1).   The patient wears a mandibular partial denture and has Branemark implants in the area of teeth #s 28 and 29 which were placed in the summer of 2003.  The patient complained of an unstable mandibular partial denture causing frequent soft tissue ulceration.  Excluding the gingival swelling, the soft tissue ulcers healed when the partial denture was left out.  This swelling was not painful but the size and color were of concern to the patient.  Also of note was that the lesion easily bled with irritation, especially while brushing. 

Figure 1. At first visit the gingival swelling around implant of tooth # 28 area was clearly apparent.  Note the swelling to be exophytic, sessile, purplish-gray and mostly on the buccal aspect of the implant.