1
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Capucha T, Krasovsky A, Abdalla-Aslan R, Ginini JG, Noy D, Emodi O, Rachmiel A, Shilo D. Central giant cell granuloma of the jaws-long-term clinical and radiological outcomes of surgical and pharmacological management. Clin Oral Investig 2024; 28:200. [PMID: 38453790 PMCID: PMC10920455 DOI: 10.1007/s00784-024-05585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES To compare long-term results of different treatment modalities in central giant cell granuloma of the maxillofacial-skeleton. Primary resection may result in major defects. Alternative treatments include pharmacological agents. As yet there has been no consensus on the use of the variety of treatment options, and few studies have reported clarifying long-term results. MATERIALS AND METHODS This retrospective study on 22 patients with 25 lesions evaluated clinical, radiological and histological features, treatment preformed and lesion recurrence. Success was defined as regression/calcification and failure as recurrence, progression or un-responsiveness. RESULTS Of the presenting patients, 77% were under age 40. Lesion prevalence was higher in the anterior mandible and left posterior maxilla. Most cases exhibited pain, tooth-mobility or mucosal-expansion. The appearance was predominantly unilocular in the maxilla and multilocular in the mandible, which also exhibited higher prevalence of cortical perforation. Up to 80% of lesions were classified as aggressive. Intralesional steroids/calcitonin were used in 7 cases. Mean follow-up was 39.8 months. Two cases showed recurrence. In 71% of the cases treated pharmacologically, calcification/regression were observed. CONCLUSIONS Our analysis indicates better outcomes using a combined approach, including both pharmacological and surgical treatments in large aggressive lesions. Pharmacological treatment resulted in decreased size or well-defined lesions, thus reducing the need for extensive bone resection. Dual treatment with corticosteroids and calcitonin showed no superior outcomes, but a larger cohort should be assessed. CLINICAL RELEVANCE There are several protocols for treatment of central-giant-cell-granuloma lesions, but most are not fully established. It is important to report results that contribute to the establishment of proven protocols. This report attempts to establish the relevance of the combined approach: pharmacological treatment followed by surgical resection.
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Affiliation(s)
- Tal Capucha
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Andrei Krasovsky
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | | | | | - Dani Noy
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Omri Emodi
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Adi Rachmiel
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dekel Shilo
- Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel.
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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2
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Mohammadi F, Bashizadehfakhar H, Aliasghari S, Gholamhoseini Z. Aggressive Multiple Central Giant Cell Granulomas of the Jaws. Case Rep Dent 2023; 2023:5410229. [PMID: 38322589 PMCID: PMC10845258 DOI: 10.1155/2023/5410229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 02/08/2024] Open
Abstract
Central giant cell granuloma (CGCG) is considered a benign intraosseous lesion with a varied range of clinical features in two subtypes, including aggressive and non-aggressive lesions. This study presents a 9-year-old boy with multiple bilateral CGCG in the mandible without any systemic disease or specific syndrome. Clinical, radiographic, and histopathological findings demonstrated the aggressive lesions. It is discussed how the differential diagnosis and treatment can be determined based on the patient's age as well as the size and manner of the lesion.
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Affiliation(s)
- Farnoush Mohammadi
- Craniofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoorieh Bashizadehfakhar
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Aliasghari
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Gholamhoseini
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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3
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Camarini C, de Souza Tolentino E. Non-surgical treatment as an alternative for the management of central giant cell granuloma: a systematic review. Clin Oral Investig 2022; 26:2111-2132. [PMID: 34599398 DOI: 10.1007/s00784-021-04193-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of non-surgical treatment as an alternative in the management of central giant cell granuloma (CGCG). MATERIAL AND METHODS A literature search was carried out in accordance with the PRISMA statement in order to answer the question "Are non-surgical treatments effective as an alternative in the treatment of CGCG?". Two examiners independently assessed eligibility, risk of bias, and extracted data, which included therapeutic protocol, side effects, and need for surgical supplementation. RESULTS Among 1712 studies, 15 were included, totaling 145 patients. Calcitonin, intralesional corticosteroids, and denosumab were the medications used. For calcitonin (n = 61), complete remission was found in 30 cases. For intralesional triamcinolone (n = 68), reduction in size was observed in most cases (n = 39). Four cases received subcutaneous denosumab and showed absence of active bone metabolism in the region, of which three presented ossification. Combination of drug therapies (n = 29) was reported in one study and included subcutaneous interferon and oral imatinib. More and less side effects were found for interferon and corticosteroids, respectively. Forty percent of patients required additional surgical treatment. CONCLUSION Despite the side effects presented and the need for additional surgery in some patients, in general, all non-surgical treatments could provide positive results as an alternative for the management of CGCG, especially with regard to reducing the size of the lesion. CLINICAL RELEVANCE CGCG is a benign bone lesion that mainly affects young individuals. Although the most common therapy is surgery, its contraindication in some patients, the large extension, and high recurrence rate of the aggressive variant have led the search for non-surgical therapies.
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Affiliation(s)
- Camila Camarini
- Department of Dentistry, Maringá State University, Avenida Mandacaru, Maringá, Paraná, 87080-000, Brazil.
| | - Elen de Souza Tolentino
- Department of Dentistry, Maringá State University, Avenida Mandacaru, Maringá, Paraná, 87080-000, Brazil
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4
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Schreuder WH, van der Wal JE, de Lange J, van den Berg H. Multiple versus solitary giant cell lesions of the jaw: Similar or distinct entities? Bone 2021; 149:115935. [PMID: 33771761 DOI: 10.1016/j.bone.2021.115935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
The majority of giant cell lesions of the jaw present as a solitary focus of disease in bones of the maxillofacial skeleton. Less frequently they occur as multifocal lesions. This raises the clinical dilemma if these should be considered distinct entities and therefore each need a specific therapeutic approach. Solitary giant cell lesions of the jaw present with a great diversity of symptoms. Recent molecular analysis revealed that these are associated with somatic gain-of-function mutations in KRAS, FGFR1 or TRPV4 in a large component of the mononuclear stromal cells which all act on the RAS/MAPK pathway. For multifocal lesions, a small group of neoplastic multifocal giant cell lesions of the jaw remain after ruling out hyperparathyroidism. Strikingly, most of these patients are diagnosed with jaw lesions before the age of 20 years, thus before the completion of dental and jaw development. These multifocal lesions are often accompanied by a diagnosis or strong clinical suspicion of a syndrome. Many of the frequently reported syndromes belong to the so-called RASopathies, with germline or mosaic mutations leading to downstream upregulation of the RAS/MAPK pathway. The other frequently reported syndrome is cherubism, with gain-of-function mutations in the SH3BP2 gene leading through assumed and unknown signaling to an autoinflammatory bone disorder with hyperactive osteoclasts and defective osteoblastogenesis. Based on this extensive literature review, a RAS/MAPK pathway activation is hypothesized in all giant cell lesions of the jaw. The different interaction between and contribution of deregulated signaling in individual cell lineages and crosstalk with other pathways among the different germline- and non-germline-based alterations causing giant cell lesions of the jaw can be explanatory for the characteristic clinical features. As such, this might also aid in the understanding of the age-dependent symptomatology of syndrome associated giant cell lesions of the jaw; hopefully guiding ideal timing when installing treatment strategies in the future.
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacqueline E van der Wal
- Department of Pathology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatrics / Oncology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
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5
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Choe M, Smith V, Okcu MF, Wulff J, Gruner S, Huisman TAGM, Venkatramani R. Treatment of central giant cell granuloma in children with denosumab. Pediatr Blood Cancer 2021; 68:e28778. [PMID: 33089644 DOI: 10.1002/pbc.28778] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/09/2020] [Indexed: 11/09/2022]
Abstract
Central giant cell granuloma (CGCG) is a benign but locally aggressive intraosseous lesion of the mandible. Historically, it is treated by curettage or resection. Medical therapy is indicated when surgery is associated with increased morbidity or in adjuvant setting to decrease recurrence. Treatment of CGCG with denosumab, a receptor activator of nuclear factor kappa-beta (RANK) ligand inhibitor, is not well studied, especially in children. Here, we describe our experience with the use of denosumab in the treatment of six children with CGCG. All patients had a favorable response with manageable side effects, which suggests that denosumab is an effective treatment option without increased morbidity.
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Affiliation(s)
- Michelle Choe
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Valeria Smith
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - M Fatih Okcu
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jade Wulff
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Stephanie Gruner
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - Rajkumar Venkatramani
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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6
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Buraczewski T, Potluri A, Costello BJ, Bilodeau EA. Multilocular radiolucency of the anterior mandible. J Am Dent Assoc 2017; 148:840-845. [PMID: 29080606 DOI: 10.1016/j.adaj.2017.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 08/04/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
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7
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Daroit NB, de Marco RG, Sant’Anna Filho M, Fritscher GG. The challenge in the treatment of central giant cell granuloma – What is the best approach? JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2017. [DOI: 10.1016/j.ajoms.2016.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Schreuder WH, van den Berg H, Westermann AM, Peacock ZS, de Lange J. Pharmacological and surgical therapy for the central giant cell granuloma: A long-term retrospective cohort study. J Craniomaxillofac Surg 2016; 45:232-243. [PMID: 28087284 DOI: 10.1016/j.jcms.2016.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 10/01/2016] [Accepted: 11/10/2016] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This is a retrospective cohort study of patients with a central giant cell granuloma (CGCG) treated at a single center to assess and compare the different surgical and non-surgical approaches. MATERIAL AND METHODS A cohort with a single histologically proven non-syndrome-related CGCG was selected and reviewed. Patients were allocated to group I (surgery), group II (pharmacotherapy), and group III (pharmacotherapy and surgery). The primary outcome was long-term radiologic response using computed tomography. Secondary outcomes were intermediate radiologic responses and occurrence and severity of side effects. RESULTS Thirty-three subjects were included in the study. The surgical group (n = 4) included 1 patient with progression during follow-up and a relatively high post-surgical morbidity. Twenty-nine patients started on various pharmacological treatment regimens (groups II and III). Fourteen patients could be managed without additional surgery. One of these lesions showed progression during follow-up. The other 15 lesions underwent additional surgery, and none showed progression during follow-up. Interferon treatment was associated with the most side effects. CONCLUSION Pharmacological agents have a role in the treatment of aggressive and non-aggressive CGCGs by limiting the renewed progression during long-term follow up and the extent and morbidity of surgical treatment.
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Affiliation(s)
- Willem Hans Schreuder
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. de Lange), Academic Medical Center, Academic Center Dentistry Amsterdam and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Henk van den Berg
- Department of Pediatric Oncology, Academic Medical Center, Emma Children Hospital and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Anne Marie Westermann
- Department of Medical Oncology, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Zachary Scott Peacock
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Fruit Street 55, MA, 02114, Boston, United States.
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. de Lange), Academic Medical Center, Academic Center Dentistry Amsterdam and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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9
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Tabrizi R. Re: Can calcitonin nasal spray reduce the risk of recurrence of central giant cell granuloma of the jaws?-a response. Int J Oral Maxillofac Surg 2016; 46:404. [PMID: 27553895 DOI: 10.1016/j.ijom.2016.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022]
Affiliation(s)
- R Tabrizi
- Oral and Maxillofacial Surgery Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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10
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Thwala LN, Préat V, Csaba NS. Emerging delivery platforms for mucosal administration of biopharmaceuticals: a critical update on nasal, pulmonary and oral routes. Expert Opin Drug Deliv 2016; 14:23-36. [PMID: 27351299 DOI: 10.1080/17425247.2016.1206074] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Protein and peptide-based drugs are preferred therapeutics due to their specificity but are mainly administered by injection. Alternative routes for peptide delivery are preferred because of their ease of administration and increased patient compliance. Areas covered: This review provides a critical overview of current strategies for non-invasive mucosal delivery routes of therapeutic proteins and peptides, with emphasis on their advantages and limitations. Selected new trends and interesting novel formulations in advanced preclinical and clinical development stages for the pulmonary, nasal and the oral route are discussed for the most relevant peptide and protein drugs in terms of their specific requirements and intended therapeutic applications. Expert opinion: Despite the low frequency of clinical breakthroughs with non-invasive routes, these remain an active research area not only due to their improved therapeutic potential, but also due to the attractive commercial outcomes they offer. Currently, a number of technologies are adopted, including combinations of penetration enhancers with protease inhibitors and/or nanotechnology-based products and a few candidates are anticipated to be approved in the near future.
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Affiliation(s)
- Lungile Nomcebo Thwala
- a Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy , University of Santiago de Compostela , Santiago de Compostela , Spain.,b Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials , Université Catholique de Louvain , Brussels , Belgium
| | - Veronique Préat
- b Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials , Université Catholique de Louvain , Brussels , Belgium
| | - Noémi Stefania Csaba
- a Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy , University of Santiago de Compostela , Santiago de Compostela , Spain
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11
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Tabrizi R, Fardisi S, Zamiri B, Amanpour S, Karagah T. Can calcitonin nasal spray reduce the risk of recurrence of central giant cell granuloma of the jaws? A double-blind clinical trial. Int J Oral Maxillofac Surg 2016; 45:756-9. [DOI: 10.1016/j.ijom.2016.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/29/2015] [Accepted: 02/29/2016] [Indexed: 12/30/2022]
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12
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Central Giant Cell Granuloma of the Mandible Requiring Multiple Treatment Modalities: A Case Report. J Oral Maxillofac Surg 2016; 74:1596-607. [PMID: 27000410 DOI: 10.1016/j.joms.2016.02.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 01/04/2023]
Abstract
Central giant cell granuloma (CGCG) is a relatively rare non-neoplastic, intraosseous lesion that exhibits a wide spectrum of clinical behavior, and its management can be particularly challenging even for experienced clinicians. The etiopathogenesis of this disease process remains unclear, although factors such as trauma, inflammatory foci, and a genetic predisposition have been implicated. Although multiple treatment modalities have been used with varying degrees of success, there is no accepted algorithm for therapeutic intervention and little is known about the reasons for success or failure of a given treatment. This article reviews the epidemiology, presentation, classification, and currently used therapies for CGCG while describing the clinical course and successful therapeutic outcome of a young female patient with an aggressive CGCG of the mandible.
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13
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Cillo JE, Basi D, Peacock Z, Aghaloo T, Bouloux G, Dodson T, Edwards SP, Kademani D. Proceedings of the American Association of Oral and Maxillofacial Surgeons 2015 Research Summit. J Oral Maxillofac Surg 2015; 74:429-37. [PMID: 26707430 DOI: 10.1016/j.joms.2015.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 11/15/2022]
Abstract
The Fifth Biennial Research Summit of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois on May 6 and 7, 2015. The goal of the symposium is to provide a forum for the most recent clinical and scientific advances to be brought to the specialty. The proceedings of the events of that summit are presented in this report.
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Affiliation(s)
- Joseph E Cillo
- Assistant Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.
| | | | - Zachary Peacock
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Tara Aghaloo
- Assistant Dean, Clinical Research; Professor, Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA
| | - Gary Bouloux
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Emory University, Atlanta, GA
| | - Thomas Dodson
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA
| | - Sean P Edwards
- Clinical Associate Professor; Director, Residency Program; Chief, Pediatric Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Deepak Kademani
- Medical Director, Department of Oral and Maxillofacial Surgery; Fellowship Director, Oral-Head and Neck Oncologic and Reconstructive Surgery, North Memorial and Hubert Humphrey Cancer Center, Minneapolis, MN
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14
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Bayar OF, Ak G. Treatment of giant cell granuloma with intralesional corticosteroid injections: a case report. J Istanb Univ Fac Dent 2015; 49:45-50. [PMID: 28955545 PMCID: PMC5573504 DOI: 10.17096/jiufd.88120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 07/04/2014] [Indexed: 11/16/2022] Open
Abstract
Giant cell granuloma is rare in the head and
neck region and most commonly affects the maxilla
and mandible. Giant cell granulomas are benign but
occasionally aggressive lesions that are traditionally
treated with surgery. Because it is a benign process,
less radical and non-surgical treatment alternatives
are required. Corticosteroid injection is a viable
alternative in the treatment of central giant cell
granuloma to avoid surgery. We aim to present a
case which was successfully treated with intralesional
corticosteroid injection in the maxilla.
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Affiliation(s)
- Ozlem Filiz Bayar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Turkey
| | - Gulsum Ak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Turkey
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15
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Noya Maiz N, de la Rosa-García E, Irigoyen Camacho ME. Immunohistochemical expression of alpha-smooth muscle actin and glucocorticoid and calcitonin receptors in central giant-cell lesions. J Oral Pathol Med 2015; 45:289-94. [DOI: 10.1111/jop.12377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Noya Maiz
- Department of Health Care; Universidad Autónoma Metropolitana; Xochimilco México City México
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16
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Martins AFL, Souza POC, Rege ICC, Morais MO, Mendonça EF. Glucocorticoids, calcitonin, and osteocalcin cannot differentiate between aggressive and nonaggressive central giant cell lesions of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:386-95. [DOI: 10.1016/j.oooo.2015.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/15/2015] [Accepted: 05/21/2015] [Indexed: 10/23/2022]
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17
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Gupta B, Stanton N, Coleman H, White C, Singh J. A novel approach to the management of a central giant cell granuloma with denosumab: A case report and review of current treatments. J Craniomaxillofac Surg 2015; 43:1127-32. [DOI: 10.1016/j.jcms.2015.04.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 03/15/2015] [Accepted: 04/10/2015] [Indexed: 11/30/2022] Open
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18
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de Carvalhosa AA, Zandonade RMC, de Souza Castro, de Araújo Estrela CR, Borges ÁH, Estrela C. 8-Year Follow-up of Central Giant Cell Lesion Mimicking Apical Periodontitis. J Endod 2014; 40:1708-12. [DOI: 10.1016/j.joen.2014.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/18/2014] [Indexed: 10/24/2022]
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Abstract
This article will review current thoughts with regard to the etiology, histopathology, diagnosis, and management of giant cell lesions of the jaws. It will attempt to point out the differences between these lesions and giant cell lesions elsewhere in the body and also the current techniques for medical management of these conditions including steroid injections, calcitonin treatment, and alpha interferon treatment.
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Affiliation(s)
- Anthony M Pogrel
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
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20
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Sadiq Z, Goodger N. Calcitonin-induced osteoplastic reaction in the mandible. Br J Oral Maxillofac Surg 2011; 49:578-9. [DOI: 10.1016/j.bjoms.2010.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 08/19/2010] [Indexed: 10/19/2022]
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21
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Triantafillidou K, Venetis G, Karakinaris G, Iordanidis F. Central Giant Cell Granuloma of the Jaws: A Clinical Study of 17 Cases and a Review of the Literature. Ann Otol Rhinol Laryngol 2011; 120:167-74. [DOI: 10.1177/000348941112000305] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives: The aim of this prospective study was to evaluate the outcome of treatment of a group of 17 patients with central giant cell granuloma (CGCG) who were treated in our clinic. Methods: A group of 17 patients with CGCG were treated in the Clinic of Oral and Maxillofacial Surgery of the “G. Papanikolaou” hospital in Thessaloniki. The age range was from 7 to 60 years. Eight patients were male and 9 patients were female. Because most of our patients (11) were less than 30 years old, the aim of the treatment was to eradicate the lesions without functional problems. All of the patients were treated by excision via curettage without a continuity defect and peripheral osteotomy. For 2 patients, the treatment was continued (after the first recurrence) with salmon calcitonin. Results: The follow-ups ranged from 1 to 15 years. All of the patients were free of the disease, without features of recurrence and without functional or aesthetic problems. Conclusions: Surgery has usually been considered to be the best method of treatment for CGCG. Most authors have proposed conservative surgical procedures (excision via curettage), especially for young patients. For aggressive lesions, supplementary treatment with calcitonin would provide good results.
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Aggressive Central Giant Cell Granuloma of the Mandible. J Oral Maxillofac Surg 2010; 68:2537-44. [DOI: 10.1016/j.joms.2009.06.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 06/30/2009] [Indexed: 02/06/2023]
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Abstract
Lesions specific for the jaws and not occurring in any other bones mostly are related to the teeth or to odontogenic tissues. Moreover, the jaws may harbor nonodontogenic bone lesions not seen in any other part of the skeleton. This paper pays attention to the diseases that are specific for the jaws, odontogenic as well as nonodontogenic. Both neoplastic and nonneoplastic entities will be discussed.
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