Pharmacological and surgical therapy for the central giant cell granuloma: A long-term retrospective cohort study
Willem Hans Schreuder1, Henk van den Berg2, Anne Marie Westermann3
1Department of Oral and Maxillofacial Surgery (Head: Prof. J. de Lange), Academic Medical Center, Academic Center Dentistry Amsterdam and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Purpose:
This is a retrospective cohort study of patients with a central giant cell granuloma (CGCG) treated at a single center to assess and compare the different surgical and non-surgical approaches.
Material And Methods:
A cohort with a single histologically proven non-syndrome-related CGCG was selected and reviewed. Patients were allocated to group I (surgery), group II (pharmacotherapy), and group III (pharmacotherapy and surgery). The primary outcome was long-term radiologic response using computed tomography. Secondary outcomes were intermediate radiologic responses and occurrence and severity of side effects.
Results:
Thirty-three subjects were included in the study. The surgical group (n = 4) included 1 patient with progression during follow-up and a relatively high post-surgical morbidity. Twenty-nine patients started on various pharmacological treatment regimens (groups II and III). Fourteen patients could be managed without additional surgery. One of these lesions showed progression during follow-up. The other 15 lesions underwent additional surgery, and none showed progression during follow-up. Interferon treatment was associated with the most side effects.
Conclusion:
Pharmacological agents have a role in the treatment of aggressive and non-aggressive CGCGs by limiting the renewed progression during long-term follow up and the extent and morbidity of surgical treatment.
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