Could MTA be a novel medicine on the recurrence therapy for GCTB?

Giant cell tumor of bone (GCTB) is a benign locally aggressive bone tumor with a shown clinical behavior of local recurrences and rare distant metastases. Surgical treatment of GCTB is associated with high morbidity, and local recurrence. Due to the high rate of pulmonary metastases recurrent GCTB may be considered as a severe disease. If the tumor reaches close to the articulating surface a subchondral bone graft can be performed without risking a higher recurrence rate. Mineral trioxide aggregate (MTA) has been widely used to repair various kinds of tooth perforations. MTA is a powder aggregate containing mineral oxides with a good biological action and may facilitate the regeneration of the periodontal ligament and formation of bone. MTA used was able to induce bone regeneration and had its action optimized. Study has showed that, in the presence of MTA, cells grow faster and produce more mineralized matrix gene expression in osteoblasts. We hypothesize that MTA may has anti-recurrence properties. For the clinical point of view, we can apply MTA in the GCTB to induce bone production, then to inhibit the recurrent of the cases. MTA may be the therapy of choice for primary as well as recurrent giant cell tumors of bone.