Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceara School of Dentistry, Fortaleza, Brazil; Department of Oral and Maxillofacial Surgery, Memorial Batista Hospital, Fortaleza, Brazil.
Department of Pathology, University of Fortaleza/Universidade de Fortaleza, School of Medicine, Fortaleza, Brazil.
Br J Oral Maxillofac Surg. 2020 Dec;58(10):e283-e289. doi: 10.1016/j.bjoms.2020.07.032. Epub 2020 Aug 2.
The aim of this prospective study was to report on the response to treatment of central giant cell lesions (CGCL) with intralesional corticosteroid injections. Consecutive cases of CGCL were treated with a biweekly intralesional injection of 20mg/ml triamcinolone hexacetonide diluted in an anaesthetic solution of 2% lidocaine/epinephrine 1:200 000 at the proportion 1:1. All patients were monitored using cone beam computed tomography. Eleven patients were treated; their ages ranged from 15-34 (mean 22 years); and eight lesions were in the mandible, and three in the maxilla. Three cases were diagnosed as non-aggressive, and eight as aggressive. Six cases presented good results (four aggressive and two non-aggressive); three cases presented a moderate response (two aggressive and one non-aggressive); and two had a poor response to treatment (both aggressive). In four cases with a good response, osteoplasty was done. In all cases with a moderate response, the remaining lesion was curetted. Cases with a poor response were submitted to either curettage or denosumab injections. Corticotherapy, as main or neoadjuvant therapy, may be an option for treatment of CGCL.
本前瞻性研究旨在报告采用皮质类固醇病灶内注射治疗中央性 giant cell 病变（CGCL）的疗效。连续的 CGCL 患者采用每两周一次的病灶内注射 20mg/ml 的曲安奈德己酮溶液，用 2%利多卡因/肾上腺素 1:200000 溶液（1:1）稀释，所有患者均采用锥形束 CT 监测。共治疗了 11 例患者；年龄 15-34 岁，平均 22 岁；8 例位于下颌骨，3 例位于上颌骨。3 例诊断为非侵袭性，8 例为侵袭性。6 例治疗效果良好（4 例侵袭性，2 例非侵袭性）；3 例疗效中等（2 例侵袭性，1 例非侵袭性）；2 例治疗效果不佳（均为侵袭性）。4 例疗效良好的病例进行了骨成形术。所有疗效中等的病例均进行了刮除术。疗效不佳的病例接受了刮除术或地舒单抗注射。皮质激素治疗，无论是作为主要治疗还是新辅助治疗，都可能是 CGCL 的一种治疗选择。
