Hacettepe University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey.
Hacettepe University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey.
J Craniomaxillofac Surg. 2024 Jun;52(6):697-703. doi: 10.1016/j.jcms.2024.03.011. Epub 2024 Mar 13.
Central and peripheral giant cell granulomas are benign entities mostly seen in mandibular anterior region at female individuals, usually with observed recurrence. Their etiology is still unclear, as is the optimal method for treating them. The aim of this study was to evaluate the incidence, treatment methods, recurrence rates, and initial and definitive correlation of central and peripheral giant cell granulomas. Patients who were referred to our clinic between 2013 and 2023 and who had the lesions' definitive diagnosis as "central giant cell granuloma" (CGCG) or "peripheral giant cell granuloma" (PGCG) were included in the study. Demographic data, recurrence rates, treatment methods, lesion location, clinical behaviors, and sizes were noted on the reports. A total of 30 lesions in 23 patients (14 PGCG and 9 CGCG) were evaluated in this study. The mean follow-up time was 62.6 months; 8 of 23 patients had systemic disease. While only 1 patient was observed to have cortical bone destruction in PCGC, all patients were found to have cortical bone destruction in CGCG (p < 0.05). In both lesions, the correlation of preliminary and definitive diagnosis was evaluated, and it was found to be 50% in PGCG while it was 77.7% in CGCG. The recurrence rates were 21.4% in PGCG and 33.3% in CGCG. Curettage was applied in all patients. Additional treatments (intralesional steroid injections, denasumab applications, resection, and graft application) were performed in 5 patients who were found to have CGCG (p = 0.004). However, there was no significant relation between treatment method and recurrence in CGCG (p > 0.05). Various peripheral lesions could mimic PGCG; thus, curettage therapy could be appropriate in the treatment of PGCG. Nevertheless, in some cases of CGCG, additional treatment methods could be more effective for preventing recurrence and any other complications.
中央性和外周性巨细胞肉芽肿是良性病变,主要见于下颌前区的女性,通常观察到复发。其病因仍不清楚,最佳治疗方法也不清楚。本研究旨在评估中央性和外周性巨细胞肉芽肿的发病率、治疗方法、复发率以及初始和最终相关性。本研究纳入了 2013 年至 2023 年间就诊于我院并确诊为“中央性巨细胞肉芽肿”(CGCG)或“外周性巨细胞肉芽肿”(PGCG)的患者。记录患者的人口统计学数据、复发率、治疗方法、病变部位、临床表现和大小。本研究共评估了 23 例患者的 30 个病变(14 个 PGCG 和 9 个 CGCG)。平均随访时间为 62.6 个月;23 例患者中有 8 例患有系统性疾病。虽然在 PGCG 中仅 1 例患者观察到皮质骨破坏,但在 CGCG 中所有患者均观察到皮质骨破坏(p<0.05)。在两种病变中,初步和最终诊断的相关性评估为 50%在 PGCG 中,77.7%在 CGCG 中。PGCG 的复发率为 21.4%,CGCG 的复发率为 33.3%。所有患者均接受了刮除术治疗。发现 CGCG 的 5 例患者(p=0.004)接受了额外治疗(病灶内类固醇注射、地舒单抗应用、切除和移植)。然而,CGCG 中治疗方法与复发之间无显著关系(p>0.05)。各种外周病变可能模拟 PGCG;因此,刮除术治疗可能适用于 PGCG 的治疗。然而,在某些 CGCG 病例中,额外的治疗方法可能更有效地预防复发和任何其他并发症。