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References

Jenkins D, Malotky M, Miremadi R, Dole M. Central giant cell granuloma of the mandible requiring multiple treatment modalities: a case report. J Oral Maxillofac Surg. 2016; 74:1596-1607
Regezi JA. Odontogenic cysts, odontogenic tumours, fibroosseous and giant cell lesions of the jaws. Mod Pathol. 2002; 15:331-341
Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A. Radiologic features of giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 81:720-726
De Lange J, van den Akker HP, Klip H. Incidence and disease-free survival after surgical therapy of central giant-cell granulomas of the jaw in the Netherlands: 1990–1995. Head Neck. 2004; 26:792-795
Marx RE, Stern D. Oral and Maxillofacial Pathology.Chicago: Quintessence Publishing Co Ltd; 2002
Stavropoulous F, Katz J. Central giant cell granulomas: a systematic review of radiographic characteristics with the addition of 20 new cases. Dentomaxillofac Radiol. 2003; 31:213-217
Farrier SL, Farrier JN, Smart MK, Nash ES. A 10 year review of the occurrence and treatment of central giant cell granuloma, in a District General Hospital. J Oral Pathol Med. 2006; 35:332-337
Bataineb AB, Al-Khateeb T, Rawashdeh MA. The surgical treatment of central giant cell granuloma of the mandible. J Oral Maxillofac Surg. 2002; 60:756-761
Harris M. Central giant cell granulomas of the jaws regress with calcitonin therapy. Br J Oral Maxillofac Surg. 1993; 2:89-94
Abdo EN, Alves LCF, Rodrigues AS, Mesquita RA, Gomez RS. Treatment of a central giant cell granuloma with intralesional corticosteroid. Br J Oral Maxillofac Surg. 2005; 43:74-76
Carlos R, Sedano O. Intralesional corticosteroids as an alternative treatment for central giant cell granuloma. Oral Surg Oral Med Oral Pathol. 2002; 93:161-166

A concealed central giant cell granuloma and its combined orthodontic and surgical management

From Volume 11, Issue 2, April 2018 | Pages 74-75

Abstract

Abstract: Central giant cell granulomas (CGCGs) can be aggressive lesions that lead to bony expansion, tooth displacement and root resorption. Often noticed by a patient when small to moderate in size, we present a case of large CGCG that was undetected in a 13-year-old due to ongoing fixed orthodontic treatment. Subsequently, her fixed appliance was vital in maintaining the rigid fixation of her teeth during surgical management and postoperative healing.

CPD/Clinical Relevance: An orthodontist is in an ideal position to identify oral medical conditions, especially rapidly growing ones, due to their more regular contact with patients.

Article

Central giant cell granulomas (CGCGs) are benign, intraosseous lesions of the jaws which are typically painless.1 The lesions account for less than 7% of benign lesions found in the jaws,2 most commonly occurring in the anterior mandible and in women under 30 years of age.3 CGCG incidence in the general population is 1.1 people per million, with the peak incidence between 10 and 19 years.4

Histologically, they consist of a fibroblastic stroma with spindle-shaped cells displaying a high mitotic rate, multiple foci of haemorrhage, plus aggregations of prominent multinucleated giant cells.5 Radiographically, they can be small, unilocular and slow growing, or large, multilocular and aggressive with mass effect on adjacent structures causing bony expansion, root resorption and tooth displacement.3,6 The primary treatment option remains to be surgical management with either curettage or block resection.7,8 Other management options include systemic calcitonin injection9 or the injection of intralesional corticosteroids.10,11

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