Medical treatment of central giant cell granuloma of the jaws

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. The lesion appears mostly in the mandible and presents as a unilocular or multilocular radiolucent defect. Although it is benign, it may be locally aggressive, causing extensive bone destruction, tooth displacement and root resorption. Two variants of the lesion, non-aggressive and aggressive, have been described. Traditionally, CGCG was treated surgically with aggressive curettage and peripheral ostectomy. The more aggressive type or recurrent lesions require wide resection, that lead to major defects in the jaws. This form of surgical treatment could be particularly disfiguring for a child or young adult. An alternative, non-surgical approach, was developed during the past several years. The present review describes several medical treatments available for CGCG that have been reported in the literature, such as corticosteroids, calcitonin and Interferon Alfa-2a. These alternatives are advantageous for large aggressive lesions in order to cure, or reduce the size of the lesion and thus minimize the need for extensive surgical resection that could result in functional and esthetic deficits.