Intralesional corticosteroid injections in the treatment of central giant cell lesions of the jaws: A meta-analytic study

Abstract

Objective: The aim of this study was to evaluate the response of treatment of central giant cell lesion to intralesional corticosteroid injections. Study Design: Review of articles indexed in PubMed on the topic between the years 1988 and 2011, and development of a descriptive meta-analysis of the results. Results: Sample of 41 patients primarily treated with intralesional corticosteroid injections was obtained, with a male female ratio of 1:0.95, being 23 aggressive and 18 non-aggressive central giant cell lesions. Triamcinolone acetonide and triamcinolone hexacetonide were the drugs used, and 78.0% cases were considered as good result, 14.6% were considered as moderate response and 7.3% were considered as negative result to treatment. Considering the aggressiveness, 88.9% of non-aggressive lesions presented a good response to treatment, in aggressive central giant cell lesions, 69.6% presented a good response to intralesional corticosteroid injections. Conclusion: In view of the results analyzed, intralesional corticosteroid injections could be considered as first treatment option for central giant cell lesion. Key words:Central giant cell lesion, corticosteroids injections, triamcinolone hexacetonide, triamcinolone acetonide.

Central giant cell granuloma of posterior mandible: Report of a case

“…In patients with aggressive tumors, alternatives to surgery include intralesional injection of corticosteroids, calcitonin, bisphosphonates, and interferon alfa-2a. [12] In the present case, a conservative approach with enucleation and curettage followed by bone grafting of the defect was performed.…”

Immunoexpression of calcitonin and glucocorticoid receptors in central giant cell lesions of the jaws

“…Central giant cell lesion is an uncommon disease, which accounts for about 7% of all intraosseous lesions affecting the jaws . It was first described by Jaffe, in 1953 .…”

“…Clinically, most cases present as an occasional finding, as CGCLs are usually asymptomatic; however, some cases are accompanied with swelling, pain, paresthesia, tooth displacement, and in rare cases nasal obstruction . Radiographic examination can reveal from small apical lesions to large multilocular radiolucencies involving large areas of the maxillary bones . Depending on the clinical and radiographic features, CGCLs can be classified as aggressive and non‐aggressive …”

Idle gossip about validity of intralesional steroid injection in treating central giant cell granuloma

“…Since the WHO has approved the successful attempts of treating central giant cell granuloma (CGCG) via intralesional injection of steroids in some cases [1], this treatment modality was promoted to be preferred to surgical intervention for it avoids gnathic/bony disfigurement [2]. Moreover, Osterne et al, [3] have conducted a would-be "meta-analysis" of 14 papers to highlight the efficacy of using intralesional injection of corticosteroid, especially intralesional triamcinolone acetonide (ITA), and to recommend its use for it is totally safe and non-invasive. Complicating matters, the duration of recruiting ITA in treating has ranged from weeks to years with determining no standards [3].…”

“…Moreover, Osterne et al, [3] have conducted a would-be "meta-analysis" of 14 papers to highlight the efficacy of using intralesional injection of corticosteroid, especially intralesional triamcinolone acetonide (ITA), and to recommend its use for it is totally safe and non-invasive. Complicating matters, the duration of recruiting ITA in treating has ranged from weeks to years with determining no standards [3].…”