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Background: Relapse of granulomatous epulis is common after surgery because of local irritations, hormonal level in vivo, or incomplete resection. Currently, if recurrence occurs, then extraction of the teeth adjacent to the lesion is commonly performed, which may influence the aesthetics or masticatory function. Thus, a more effective and less aggressive treatment method is urgently demanded, particularly for the recurring lesion. This study investigated the effects of the intralesional pingyangmycin (PYM) injections for the recurrent granulomatous epulis and assessed the complications., Material and Methods: A total of 16 patients with recurrent granulomatous epulis underwent intralesional PYM injections, between July 2010 and June 2014. The effects and complications of the treatment were retrospectively reviewed., Results: The total number of injections performed was 48 (for all patients). The median number of injections per patient was three (range, two to four). All cases completely recovered with no recurrence and resorption of the alveolar bone after a follow-up of more than 12 months. The complications included slight bleeding, local swelling and pain following injection. All these symptoms resolved 7 to 10 days after the injection., Conclusions: In summary, intralesional PYM injections may be a preferred option for recurring granulomatous epulis.

Recurrence is very common if the mucoceles of the anterior lingual salivary glands (ALSGs) are treated by surgery due to its anatomic characteristics. Therefore, more effective and less invasive treatment methods are urgently required to be applied instead of surgery. In this study, 40 patients with the mucocele of the ALSGs received the intralesional injections of pingyangmycin, and the median number of injections per patient was 2.075 (range, 1-3). All cases completely recovered with no recurrence after follow-up of more than 16 months. The complications included the local swelling, pain, and ulceration following injection, and all these symptoms resolved 7-10 days after the injection. Taken together, sclerotherapy with pingyangmycin is an effective and safe treatment method for the mucocele of the ALSGs and may be the primary treatment modality., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Two hundred and sixty patients with oral and facial venous malformations received intralesional injections of either pingyangmycin, sodium morrhuate, or pingyangmycin alternating with sodium morrhuate. Results were rated excellent, good, fair, or poor, depending on clinical outcome. The prevalence of an "excellent" rating in the combined sclerotherapy group (82%) was higher than that in the pingyangmycin group (71%) and the sodium morrhuate group (61%). Swelling and pain following injection were commonly associated with the use of sodium morrhuate. Sclerotherapy with pingyangmycin or sodium morrhuate is an effective and safe treatment for oral and facial venous malformations. Alternate injection of pingyangmycin and sodium morrhuate appears to be more effective for venous malformations than using sclerosant alone.

Background Previous studies have implicated vascular destabilization and changes in extracellular matrix ( ECM) composition in venous malformations ( VMs). Objectives To evaluate the expression levels of the connective tissue growth factor ( CCN) family of matricellular proteins in VMs and explore their association with vascular destabilization. Methods The expression levels of CCNs 1-6, transforming growth factor ( TGF)-β, phosphorylated Tie2 and phosphorylated platelet-derived growth factor receptor β in normal human skin tissues and VMs were detected by immunohistochemistry. Correlation between tested proteins was explored using the Spearman rank correlation test, followed by clustering analysis. In vitro studies using human umbilical vein endothelial cells ( HUVECs) were performed for mechanism investigation. Results Expression of CCN2 was found to be strongly positive in fibroblast-like cells, endothelial cells and around blood vessels in normal human skin tissues, but it was significantly downregulated in VMs. Correlation analyses showed that expression levels of CCN2 and TGF-β in VMs were positively correlated. The immunoreactivity of CCN2 was also closely correlated with perivascular α-smooth muscle cell actin+ cell coverage in VMs. Moreover, in vitro studies in HUVECs indicated that CCN2 might act as a downstream target of TGF-β, as demonstrated by the findings that treatment with exogenous TGF-β or exogenous CCN2 could significantly upregulate the expression level of CCN2, and increase the expression levels of ECM components. Upregulation of the TGF-β/ CCN2 pathway was also detected in bleomycin-treated VM specimens. Conclusions This study unmasks the downregulation of the TGF-β/ CCN2 pathway in VMs, and indicates its target potential for sclerotherapy. [ABSTRACT FROM AUTHOR]