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Corrêa FA, de Arruda JAA, Drumond VZ, Cepeda IVB, Tarquinio SBC, Silva TA, Abreu LG, Rivero ERC, Mesquita RA, Etges A. Pharmacological therapy for central giant cell granuloma of the jaws: A systematic review. J Clin Exp Dent 2024; 16:e885-e897. [PMID: 39219829 PMCID: PMC11360452 DOI: 10.4317/jced.61490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/10/2024] [Indexed: 09/04/2024] Open
Abstract
Background Pharmacological therapy has been used as an alternative or complementary approach to surgery in central giant cell granuloma (CGCG) of the jaws. This systematic review examined the effectiveness of pharmacological therapy for CGCG of the jaws, focusing on clinical outcomes. Material and Methods Electronic searches were performed in six databases. Case reports and/or cases series were included. The Kaplan-Meier survival analysis method was used to evaluate outcomes related to clinical resolution and recurrence. The risk of bias was assessed using the Joanna Briggs Institute tool. Results A total of 74 studies comprising 205 cases of CGCG were included. About 65.4% of cases occurred in individuals under 20 years of age. Most of the treated patients were women (61%) and the mandible (72.2%) was the most reported site. Curettage and enucleation before or after pharmacological therapy were reported in 28.3% and 19% of cases, respectively. The main pharmacological agent used was triamcinolone (37.5%). Complete resolution of CGCG was reported at a rate of 77.1%, while side effects were experienced by 9.8% of individuals. The recurrence rate was 6.8%. Conclusions Pharmacological therapy may be an effective and safe option for managing CGCG, especially in the young population. Although the overall success rate in achieving complete resolution is encouraging, further controlled studies are needed to refine drug selection and protocols. Key words:Calcitonin, Central giant cell lesion, Denosumab, Interferon, Pharmacological therapy, Triamcinolone.
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Affiliation(s)
| | - José-Alcides-Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Tarcília-Aparecida Silva
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas-Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Elena-Riet-Correa Rivero
- Department of Pathology, Health Sciences Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ricardo-Alves Mesquita
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Etges
- Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
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Ali M, Hamama M, Kheder K, Haidar O. Central giant cell granuloma formation in an edentulous area in the posterior portion of mandible: A case report. Int J Surg Case Rep 2023; 112:108971. [PMID: 37883880 PMCID: PMC10667862 DOI: 10.1016/j.ijscr.2023.108971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Central Giant Cell Granuloma (CGCG) is a non-neoplastic benign lesion. It is primarily observed in the maxilla and mandible, with the mandible being the more reported site of the lesion. The lesion often manifests in the anterior regions of the mandible, extending occasionally across the midline. This case reports a rare presentation in the posterior portion of the mandible, in an edentulous area. PRESENTATION OF CASE A 33-year-old female with a history of extraction of teeth 36 and 37 six months ago presented with a main complaint of a mass in the oral cavity. The oral examination revealed an expansive multilocular mass (4 × 3 cm) located on the alveolar ridge in the left posterior portion of the mandible, extending around tooth 33 with an intact masseter muscle. The histopathological findings were consistent with CGCG. Consequently, the lesion was surgically removed with no clinical or radiological recurrence observed during the 4-month post-operative follow-up. DISCUSSION While previous reports of CGCG in the posterior portion of the jaw showed destructive lesions that caused mandibular ramus destruction along with swollen masseter muscle, this case reports no involvement of the masseter muscle. Also, while some studies linked CGCG to tooth-bearing regions, our case suggests a possible traumatic link even after extraction. CONCLUSIONS This case presents a rare CGCG occurrence in the posterior jaw, notably without masseter muscle involvement. It also indicates that CGCG can manifest in edentulous regions.
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Affiliation(s)
- Mhammad Ali
- Al-Andalus University for Medical Science, Tartus, Syria.
| | | | - Kheder Kheder
- Al-Andalus University for Medical Science, Tartus, Syria
| | - Orwa Haidar
- Mesyaf National Hospital, Department of Oral and Maxillofacial Surgery, Syria
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Gupta S, Sharma D, Hooda A, Sharma VK, Kamboj M. Unravelling the role of immunohistochemistry in giant cell lesions of jaws: A systematic review. J Oral Maxillofac Pathol 2023; 27:181-194. [PMID: 37234327 PMCID: PMC10207225 DOI: 10.4103/jomfp.jomfp_18_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/28/2022] [Accepted: 06/03/2022] [Indexed: 05/27/2023] Open
Abstract
Controversies exist in literature regarding nature, pathogenesis, and behaviour of giant cell lesions (GCLs) of jaws. Studies were attempted to solve these mysteries with immunohistochemical analysis, using various biological markers. Thus, the aim of this review is to appraise the role of immunohistochemistry (IHC) in evaluating the pathogenesis, cellular phenotype, nature, and behaviour of GCLs of jaws. PubMed, PubMed Central, and Clinical Key (Medline) databases were searched electronically irrespective of date of publication with assortment of several independent terms. Fifty-five articles that fulfilled the eligibility criteria were included in the review. Out of 55 included articles, 49 were associated with nature, pathogenesis, and behaviour and six articles were associated with treatment and outcome prediction. Although IHC solved some of the controversies associated with GCLs of jaws such as the osteoclastic phenotype of multinucleated giant cells, immunoexpression of proliferative markers does not distinct non-aggressive from aggressive central GCL but the nature, histogenesis, pathogenesis, and exact behaviour still remain debatable. With regard to formulation of treatment plan, immunohistochemical analysis revealed that expression of glucocorticoid and calcitonin receptors could act as a tool to decide the therapeutic strategy and aid in therapeutic adjustments according to evolution of the lesion.
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Affiliation(s)
- Shruti Gupta
- Department of Oral Anatomy, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Deepti Sharma
- Department of Oral and Maxillofacial Pathology, Christian Dental College, Ludhiana, Punjab, India
| | - Anita Hooda
- Department of Oral Anatomy, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Vishal Kumar Sharma
- Department of Orthodontics, Desh Bhagat Dental College, Mandi Gobindgarh, Punjab, India
| | - Mala Kamboj
- Department of Oral Pathology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Smriti K, John E, Pentapati KC, Gadicherla S, Bhagania M. Intra-Lesional Medicaments for the Management of Intra-Osseous Lesions of Maxilla and Mandible - Systematic Review. J Int Soc Prev Community Dent 2020; 10:36-45. [PMID: 32181219 PMCID: PMC7055339 DOI: 10.4103/jispcd.jispcd_295_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/21/2019] [Indexed: 11/30/2022] Open
Abstract
Aims and Objectives: This study aimed to review the success or remission of intralesional medicaments in the management of intraosseous lesions in the oral cavity. Materials and Methods: A comprehensive search was performed in two databases (PubMed and Scopus). Research articles, case reports, case series, and clinical trials were included. Review articles, lesions not involving the bone, incomplete reporting, any other treatment other than intralesional medicaments to treat intraosseous bone lesions, publications without any treatment, and letter to editor were excluded. Data on remission (complete, partial, or no remission), details and regimen of the intervention, number of participants, and follow-up in months were recorded. Results: A total of 653 publications were available for title and abstract screening after the removal of duplicates. Seven articles were excluded, which were not in English. After title and abstract screening, a total of 88 publications were available for full-text screening. Fifty-five articles were included in qualitative synthesis. A total of 168 patients from 55 publications were evaluated. Minimum follow-up was 1 month and maximum was 264 months. More than two-third (n = 38) of the publications were case reports on single patient. More than two-third (n = 38) of the publications had complete remission. Conclusion: Intralesional medications have shown variable success rates. Extensive lesions may undergo intralesional medications followed by surgical management.
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Affiliation(s)
- Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Evit John
- MPH Candidate, School of Public Health, University of Texas Health Sciences Centre, Houston, Texas, USA
| | - Kalyana-Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Srikanth Gadicherla
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Manish Bhagania
- Oral and Maxillofacial Surgery, Boston University, Boston, MA, USA
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de Mendonça RP, Mitre GP, Real FH, da Silva Kataoka MS, de Melo Alves Júnior S, Vianna P, Da Silva Júnior NG, de Jesus Viana Pinheiro J. Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study. Head Neck Pathol 2019; 14:497-502. [PMID: 31297738 PMCID: PMC7235135 DOI: 10.1007/s12105-019-01053-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/06/2019] [Indexed: 12/11/2022]
Abstract
Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the head and neck with potential for aggressive and locally destructive behaviour. Lesions of the maxilla tend to expand more than those of the mandible due to the thinner cortices and spongy tissue of this location. Surgical removal is the most common treatment; however, it may be disfiguring in aggressive cases, especially for lesions located in the maxilla. Alternative treatments, such as intralesional corticosteroid injections, have been performed with satisfactory results. We report a case of a 12-year-old female patient with a CGCG of the left maxilla that was treated with 40 doses of intralesional triamcinolone acetonide infiltrations combined with alendronate sodium and calcium carbonate. Clinical and imaging follow-up over 12 years demonstrates improvement in the patient's condition.
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Affiliation(s)
- Raíssa Pinheiro de Mendonça
- Department of Oral Pathology, School of Dentistry, Federal University of Ceara, Rua Monsenhor Furtado, Fortaleza, Ceara 60430-355 Brazil
| | - Geovanni Pereira Mitre
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Flavio Henrique Real
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Para, Avenida Augusto Correa, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Maria Sueli da Silva Kataoka
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Sérgio de Melo Alves Júnior
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | | | - Newton Guerreiro Da Silva Júnior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Para, Avenida Augusto Correa, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - João de Jesus Viana Pinheiro
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
- Cell Culture Laboratory, Department of Oral Pathology, School of Dentistry, Federal University of Para - UFPA - Institute of Health Sciences, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
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