Authors’ Protocol of Central Giant Cell Granuloma Effective Treatment in the Jawbone

TL;DR

A new minimally invasive treatment for jawbone tumors reduces recurrence and preserves jaw structure, offering better patient outcomes.

Contribution

A novel treatment protocol combining steroids, surgery, and chemical cauterization for central giant cell granulomas is proposed and evaluated.

Findings

The protocol effectively reduced tumor size and preserved jaw structure in 13 patients.

Only one recurrence was observed, with minor and transient complications.

The treatment worked equally well for aggressive and non-aggressive lesions across different ages.

Abstract

Central giant cell granuloma of the jaw is a benign and rare disease (incidence of approximately 1–2 per 1,000,000 individuals per year). The solid tumor is a potentially aggressive bone lesion that can cause pain, facial deformity, tooth loss, and pathological fractures. Standard surgical treatment often results in significant tissue loss and functional impairment, especially in younger patients. This study presents a minimally invasive treatment protocol combining multiple weekly intralesional steroid injections with removal of residual tumor tissue and chemical cauterization with Carnoy’s solution to reduce recurrence. The approach allows preservation of jaw structure while effectively controlling tumor growth. Clinical and radiological follow-up demonstrated that the method is safe, well-tolerated, and can prevent recurrence when applied consistently, even in aggressive cases. These findings offer a practical strategy for clinicians, improving patient outcomes and supporting further research on conservative management of central giant cell granulomas.

Background: Central giant cell granuloma of the jaw is a benign but potentially aggressive lesion that can cause pain, facial deformity, tooth loss, and jaw destruction. Many treatment methods are described in the literature, but the less invasive ones are associated with a higher recurrence rate. For several decades, extensive bone resection procedures have been the most effective treatment to date. This study aimed to evaluate a minimally invasive treatment protocol combining multiple weekly intralesional steroid injections with surgical removal of residual tumor tissue and chemical cauterization using Carnoy’s solution. Methods: Thirteen patients with histologically confirmed central giant cell granulomas of the jaws were treated according to the protocol, including weekly triamcinolone injections and, when necessary, fenestration of the cortical bone to access residual lesions. Patients were monitored clinically and radiologically over six years, with reconstruction of bone defects using autogenous grafts and platelet-rich fibrin. Results: The treatment effectively reduced tumor size, restored cortical bone, and allowed preservation of jaw structure. Only one recurrence was observed, and complications were minor and transient. The protocol was equally effective for both aggressive and non-aggressive lesions, regardless of patient age or comorbidities. Conclusions: These findings suggest that combining pharmacological and surgical approaches with chemical cauterization provides a safe, effective, and tissue-preserving strategy for managing central giant cell granulomas, minimizing recurrence while reducing surgical morbidity.

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