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Advantages and disadvantages of surgical and non-surgical treatment of central giant-cell granuloma: A Review of literature

Hind Ahmed Osman Elhag, Mohammed Hassan Babikir, Basil Tarakji


Background: Central giant-cell granuloma (CGCG) is a non-neoplastic benign bony lesion of unknown origin. However, genetic abnormalities, trauma, inflammation, and intrabony hemorrhage are likely causative factors. It occurs most frequently in young adults under 30 years of age; females are affected more frequently than males and the anterior part of the jaw and the mandible are the sites most affected. In radiography, it appears either as a unilocular or multilocular radiolucency. According to its biological characteristics, two variants exist: The aggressive variant shows rapid growth with pain, root resorption, tooth displacement, jaw expansion, and a tendency for recurrence; the nonaggressive variant, is usually asymptomatic and slow growing. Aim: This study aims to highlight the advantages and disadvantages of the primary approaches to the treatment of CGCG through review of the existing literature. Conclusion: The different clinical behaviour of the lesions, that are difficult to distinguish histologically, lead to different treatment modalities ranging from radical resection to non-surgical therapy in the form of steroids, calcitonin, or interferon. Non-surgical therapy outcomes fail to achieve the surgery results in monitoring the lesions with restricted long-term follow-up. Most cases require further surgical intervention. Newer combination therapy is under investigation, using both surgical and the medical treatments to control the lesions. Although this is a rare bone tumor, controlled clinical studies with standardized procedures should be implemented to increase understanding. Clinical Significance: There is significant lack of agreement between the different treatment options (ranging from surgical to non-surgical). This is due to the diverse clinical behaviour of the lesion. Surgical treatment is widely accepted and regarded as the common treatment choice. However, it is also variable, with en bloc resection giving the most desirable outcome. Non-surgical options (corticosteroids, calcitonin, and interferon) have been applied and their valuable outcomes that must be considered.


Calcitonin; central giant-cell granuloma; corticosteroids; interferon; primary non-surgical treatment; primary surgical treatment

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