Tosco Paolo, Tanteri Giulia, Iaquinta Caterina, Fasolis Massimo, Roccia Fabio, Berrone Sid, Garzino-Demo Paolo
Division of Maxillofacial Surgery, Department of Clinical Physiopathology, University of Turin, Italy.
J Craniomaxillofac Surg. 2009 Oct;37(7):380-7. doi: 10.1016/j.jcms.2009.04.002. Epub 2009 May 17.
Central giant cell granuloma (CGCG) is an uncommon benign bony lesion that occurs in the mandible and maxilla. The clinical behaviour of CGCG ranges from a slow-growing asymptomatic swelling to an aggressive lesion that presents pain, local bone destruction, root resorption and tooth displacement. Therapeutic options have varied greatly over the years. Non-surgical treatments with alpha interferon (alpha-IFN), calcitonin and corticosteroids have been described and their benefits may be worthy of consideration. Surgery is considered the traditional treatment and it is still the most accepted one, however in the literature not all authors agree on the type of surgery which should be performed. Although en bloc resection provides the lowest recurrence rate, only a few single case reports describe the use of this technique followed by reconstruction with autogenous bone grafts. The authors report their experience with en bloc resection of 18 wide CGCGs which had not been previously treated medically. Immediate reconstruction was carried out for all cases and in one, a fibula free flap was used to reconstruct the mandible. No recurrence was observed. After complete healing of the graft, prosthetic rehabilitation via implants was performed. This allowed the best functional and aesthetic results.
中央巨细胞肉芽肿（CGCG）是一种罕见的良性骨病变，发生于下颌骨和上颌骨。CGCG的临床行为范围从生长缓慢的无症状肿胀到表现为疼痛、局部骨质破坏、牙根吸收和牙齿移位的侵袭性病变。多年来，治疗选择差异很大。已描述了使用α干扰素（α-IFN）、降钙素和皮质类固醇的非手术治疗方法，其益处可能值得考虑。手术被认为是传统治疗方法，并且仍然是最被接受的方法，然而在文献中，并非所有作者都对应实施的手术类型达成一致。尽管整块切除提供了最低的复发率，但仅有少数单病例报告描述了使用该技术并随后用自体骨移植进行重建。作者报告了他们对18例未经药物治疗的广泛CGCG进行整块切除的经验。所有病例均进行了即刻重建，其中1例使用游离腓骨瓣重建下颌骨。未观察到复发。移植完全愈合后，通过种植体进行修复康复。这实现了最佳的功能和美学效果。
