Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases

Abstract

Central giant cell granuloma (CGCG) is an uncommon benign bony lesion that occurs in the mandible and maxilla. The clinical behaviour of CGCG ranges from a slow-growing asymptomatic swelling to an aggressive lesion that presents pain, local bone destruction, root resorption and tooth displacement. Therapeutic options have varied greatly over the years. Non-surgical treatments with alpha interferon (alpha-IFN), calcitonin and corticosteroids have been described and their benefits may be worthy of consideration. Surgery is considered the traditional treatment and it is still the most accepted one, however in the literature not all authors agree on the type of surgery which should be performed. Although en bloc resection provides the lowest recurrence rate, only a few single case reports describe the use of this technique followed by reconstruction with autogenous bone grafts. The authors report their experience with en bloc resection of 18 wide CGCGs which had not been previously treated medically. Immediate reconstruction was carried out for all cases and in one, a fibula free flap was used to reconstruct the mandible. No recurrence was observed. After complete healing of the graft, prosthetic rehabilitation via implants was performed. This allowed the best functional and aesthetic results.