Calcitonin with and without intralesional corticosteroid injection for management of aggressive central giant cell granuloma of the jaws

Abstract Purpose This study was planned to evaluate the effect of subcutaneous injection of calcitonin with and without intralesional corticosteroid injection for management of aggressive central giant cell granuloma (CGCG) of the jaws. Patients and methods Prospective noncontrolled clinical study that was conducted on 16 patients having aggressive CGCG of the jaws. The patients were randomly divided into two equal groups. Group I eight patients received salmon calcitonin subcutaneous injections. Group II eight patients received salmon calcitonin subcutaneous injections with intralesional corticosteroid injections. Patients in both groups were evaluated for 6 months clinically for presence of pain, mobility of the related teeth, color of the overlying mucosa and laboratory investigation monthly for serum calcium, serum phosphorus, parathyroid hormone and adrenocorticotropic hormone for patients who received intralesional corticosteroid injection. Radiographically panoramic radiograph was taken at 3 and 6 months postinjection and computed tomography at the end of 6 months postinjection. Results Six months postinjections, clinically 75% of our patients in both groups showed improvement in subjective feeling of pain and discomfort, decrease in tooth mobility related to lesion and insignificant improvement in facial asymmetry. Only one (12.5%) patient in group II showed negative response by increasing in lesion size. According to laboratory investigations only serum calcium showed mild decrease blew normal level in half of our patients. Radiographically 75% of our patients in both groups showed significant increase in calcification within the lesions with considerable thickening of the cortices. Reduction in lesion volume in group I was 27.79% and in group II was 21.05%. Conclusion There was no significant difference in the percentage of lesions size reduction between the two groups after 6 months of therapy. Calcitonin reduces the size of CGCG, with increased calcification and thickening of the cortical plates, provides a clear definition of the lesion limits, facilitating the surgical procedure decreasing the need for complex reconstruction procedures.