title: Combined treatment of aggressive central giant cell granuloma in the lower jaw.
abstract: BACKGROUND
  The aggressive type lesions of central giant cell granuloma (CGCG) require wide resection that leads to major defects in the jaws. This form of surgical treatment can be particularly disfiguring. A number of alternative non-surgical therapies have been advocated in recent years for the management of the central giant cell granuloma (CGCG). These include calcitonin injections and nasal spray, intralesional steroid injections and subcutaneous interferon injections.
  
  
  METHODS
  A large central giant cell granuloma aggressive type lesion in the mandible of a 24-year-old patient was treated successfully by intralesional injection of corticosteroid and nasal spray calcitonin that was followed by curettage with peripheral ostectomy with preservation of the continuity of the mandible and the teeth. At the 5-year clinical and radiological follow up there was no sign of recurrence.
  
  
  CONCLUSIONS
  This combined medical and surgical treatment is advantageous for large aggressive lesions in order to reduce the size of the lesion and thus minimize the need for extensive bone resection and loss of teeth that can result in functional and aesthetic defects.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel. adi_rach@netvision.net.il
authors.forename: Adi
authors.initials: A
authors.lastname: Rachmiel
authors.forename: Omri
authors.initials: O
authors.lastname: Emodi
authors.forename: Edmond
authors.initials: E
authors.lastname: Sabo
authors.forename: Dror
authors.initials: D
authors.lastname: Aizenbud
authors.forename: Micha
authors.initials: M
authors.lastname: Peled
mesh_terms: D000281:Administration, Intranasal; D000779:Anesthetics, Local / Q000008:administration & dosage; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003475:Curettage; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006101:Granuloma, Giant Cell / Q000601:surgery*; D006801:Humans; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage; D008336:Mandibular Diseases / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D014662:Vasoconstrictor Agents; D002116:Calcitonin; D008012:Lidocaine; D014222:Triamcinolone Acetonide; D004837:Epinephrine