Central Giant Cell Granuloma

Overview

Central giant cell granuloma is a benign intraosseous lesion of the jaws occurringmostly in persons under the age of 30. Females comprise 65 % of all the cases. Mandible isaffected 2 to 3 times more often than maxilla. The aetiology of this disease remains unclear, butthe occurrence of central giant cell granuloma has been repeatedly described in connection witha primary tooth injury. That was also the case of our patient. At the age of three, he suffered aninjury of the tooth No. 51, but he visited our dental office four years later at the age of sevendue to an impacted tooth No. 11, which was dislocated high into the vestibule. The dislocationwas caused by a demarcated radiolucent lesion that was removed by simple curettage. Theadjacent permanent teeth follicles were left in situ. The histological examination confirmed theclinical diagnosis of a central giant cell granuloma. Within 19 months, the defect healed withthe osseous tissue, development of all adjacent permanent teeth was not impaired andorthodontic treatment commenced that continues successfully to date.The relationship between central giant cell granuloma and other giant cell processes of thejaws especially bone cysts is still being discussed. Recent genetic foundings have brought newlight into this. The lesion has two variants – non-aggressive and aggressive that clinically differfrom each other. The clinical manifestations range from asymptomatic processes and dislocationsof adjacent teeth to rapid growth, pain, destruction of bone corticalis and resorption of adjacent teeth. Therapeutical possibilities include both classical surgery and medicamentoustherapy with intralesional administration of corticoids or systemic therapy with calcitonin.

Key words:
central giant cell granuloma