Central Giant Cell Granuloma in Maxillary: Treatment and Literature Review

Objective: We report the case of combined surgical-pharmacological treatment with local administration of intralesional corticosteroids (IIC) for the management of aggressive central giant cell granuloma (CGCG-A) in the upper jaw with a 4-year follow up. Methodology: A 2-stage treatment is planned, surgical curettage and intralesional injections with 20 mg/ml triamcinolone diluted in a 2% lidocaine/epinephrine anesthetic solution of 1:200,000 in a 1:1 ratio. Use 1mL of infiltrate solution for every 1 cm3 of radiolucent lesion area applied every 2 weeks, for 6 weeks. Discussion: At 6 months, complete clinical remission and decreased tooth mobility were observed. Radiologically, there were signs of bone apposition and a decrease in the volume of the lesion. At 3 years there was corticalization of the maxillary sinus without invasion, well-defined maxillary cortical and hyperdensity of the trabeculate. Clinically tooth mobility was not observed, healthy mucous membranes and normal eruption of teeth in root formation. Four years later no recurrence is noticed. Conclusion: Combined treatment with local administration of IIC is a conservative alternative for the treatment of CGCG -A and can be considered as a therapeutic option to avoid high morbidity without affecting aesthetic and functionality, loss of teeth, and impair the quality of life of a young patient.