title: Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant-cell granuloma in 21 cases.
abstract: Central giant-cell granulomas are benign, but occasionally aggressive, lesions that traditionally have been treated surgically. 21 cases of central giant-cell granuloma of the jaw were treated with intralesional injection of corticosteroids. The treatment protocol adopted was intralesional injection of 20mg/ml triamcinolone hexacetonide diluted in an anaesthetic solution of 2% lidocaine/epinephrine 1:200,000 in the proportion 1:1; 1.0ml of the solution was infiltrated for every 1cm(3) of radiolucid area of the lesion, totalling 6 biweekly applications. Ten patients had aggressive lesions and 11 nonaggressive. Two patients showed a negative response to the treatment and underwent surgical resection, 4 showed a moderate response and 15 a good response. 8 of the 19 who had a moderate-to-good response to the drug treatment underwent osteoplasty to reestablish facial aesthetics. In these cases, only mature or dysplastic bone was observed, with the presence or absence of rare giant multinucleated cells. The advantages of this therapy are its less-invasive nature, the probable lower cost to the patient, lower risk and the ability to treat the lesion surgically in the future, if necessary.
authors.affiliation: Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Ceará Federal School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: R L M
authors.initials: RL
authors.lastname: Nogueira
authors.forename: R C
authors.initials: RC
authors.lastname: Teixeira
authors.forename: R B
authors.initials: RB
authors.lastname: Cavalcante
authors.forename: R A
authors.initials: RA
authors.lastname: Ribeiro
authors.forename: S H B
authors.initials: SH
authors.lastname: Rabenhosrt
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006101:Granuloma, Giant Cell / Q000188:drug therapy*; D006801:Humans; D015552:Injections, Intralesional; D007571:Jaw Diseases / Q000188:drug therapy*; D008297:Male; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide