RESUMO
Central and peripheral giant cell granulomas are benign entities mostly seen in mandibular anterior region at female individuals, usually with observed recurrence. Their etiology is still unclear, as is the optimal method for treating them. The aim of this study was to evaluate the incidence, treatment methods, recurrence rates, and initial and definitive correlation of central and peripheral giant cell granulomas. Patients who were referred to our clinic between 2013 and 2023 and who had the lesions' definitive diagnosis as "central giant cell granuloma" (CGCG) or "peripheral giant cell granuloma" (PGCG) were included in the study. Demographic data, recurrence rates, treatment methods, lesion location, clinical behaviors, and sizes were noted on the reports. A total of 30 lesions in 23 patients (14 PGCG and 9 CGCG) were evaluated in this study. The mean follow-up time was 62.6 months; 8 of 23 patients had systemic disease. While only 1 patient was observed to have cortical bone destruction in PCGC, all patients were found to have cortical bone destruction in CGCG (p < 0.05). In both lesions, the correlation of preliminary and definitive diagnosis was evaluated, and it was found to be 50% in PGCG while it was 77.7% in CGCG. The recurrence rates were 21.4% in PGCG and 33.3% in CGCG. Curettage was applied in all patients. Additional treatments (intralesional steroid injections, denasumab applications, resection, and graft application) were performed in 5 patients who were found to have CGCG (p = 0.004). However, there was no significant relation between treatment method and recurrence in CGCG (p > 0.05). Various peripheral lesions could mimic PGCG; thus, curettage therapy could be appropriate in the treatment of PGCG. Nevertheless, in some cases of CGCG, additional treatment methods could be more effective for preventing recurrence and any other complications.
Assuntos
Granuloma de Células Gigantes , Recidiva , Humanos , Granuloma de Células Gigantes/patologia , Granuloma de Células Gigantes/terapia , Feminino , Estudos Retrospectivos , Masculino , Adulto , Pessoa de Meia-Idade , Incidência , Adolescente , Doenças Mandibulares/epidemiologia , Doenças Mandibulares/terapia , Adulto Jovem , IdosoRESUMO
PURPOSE: The aim of this study was to investigate the effects of membrane stabilization by suturing the sinus membrane and dental implant insertion on endo-sinus bone formation in lateral sinus lifting performed without grafting. MATERIALS AND METHODS: Maxillary sinus lift surgery using the lateral approach was performed bilaterally in 30 New Zealand white rabbits. The maxillary sinus areas were divided into control and test groups. In the control group, a titanium screw was placed after sinus membrane elevation, while in the test group, the sinus membrane was sutured to the lateral walls and a titanium screw was placed in the center of the alveolar crest. The animals were sacrificed at 4 and 8 weeks. Samples were collected, and micro-computed tomography (micro-CT) analysis was performed. The volume of newly formed bone, percentage of osseointegration, sinus volume, residual bone height, and protrusion length of the implants were measured using micro-CT analysis. RESULTS: The sinus volume, volume of newly formed bone, and percentage of osseointegration in the test group were significantly higher than those in the control group at 4 weeks (p = 0.01, p = 0.04, p = 0.02, respectively) While the volume of newly formed bone was 17.1 ± 3.08 mm3 in the control group, it was 26.9 ± 14.26 mm3 in the test group at 4 weeks. The volume of newly formed bone was significantly decreased from 26.9 ± 14.26 mm3 to 17 ± 3.66 mm3 at 8 weeks (p = 0.02). No significant difference in residual bone height was found at 4 and 8 weeks (p = 0.07). No significant difference in implant protrusion length was found between the control and test groups (p = 0.18). Protrusion length and new bone formation in the sinus showed a negative relationship (p = 0.01). CONCLUSION: Suturing the sinus membrane to the lateral sinus wall is an effective approach for increasing osseointegration, bone volume, and sinus volume in the short-term. A slow-absorbing suture material can be used to maintain sinus and bone volumes in the long-term.