REHABILITATION OF CENTRAL GIANT CELL GRANULOMA WITH ILIAC GREFT AND REMOVABLE SPACE MAINTAINER: CASE REPORT

Abstract

Purpose: Central giant cell granuloma is a nonodontogenic pathological lesion that usually located in the mandible and maxilla. The aetiology of giant cell granuloma is undefined. Surgical removal is the most commonly applied therapy. Our aim was to report rehabilitation of central giant cell granuloma with iliac graft and removable space maintainer. Case Report: A 10-years-old child was referred to our clinic complaining of swelling in the mandibular anterior region. The parents of the patient were reported that a surgical operation was done in mandibular anterior region of the patient one year ago. They also reported that this lesion was recurred six months after first surgery. The recurred lesion was removed under general anesthesia, mandibular left central, lateral, canine and first premolar teeth were extracted. Iliac crest graft was harvested and fixed to the mandible. The histopathology report confirms the diagnosis of a central giant cell granuloma. The patient's postoperative 12 months follow-up exam was uneventful. The patient was referred for removable space maintainer. Conclusion: Aggressive lesions such as central giant cell granuloma observed 72% recurrence rate to the literature. Conservative methods such as corticosteroid injection, systemic calcitonin’s success isn’t definite on the recurred lesion. The surgical treatment may cause major defects in jaw bones and changes the facial contours, the repair of the defect with iliac bone graft was performed to solve aesthetic problems and facilitate the further prosthetic rehabilitation

Keywords

• central giant cell granuloma, iliac crest graft, removable space maintainer

SANTRAL DEV HÜCRELİ GRANÜLOMANIN İLİAK GREFT VE HAREKETLİ YER TUTUCU APAREY İLE REHABİLİTASYONU: OLGU SUNUMU

Abstract

Amaç: Santral dev hücreli granüloma sıklıkla mandi- bula ve maksillada lokalize olan, non-odontojenik patolojik bir lezyondur. Etiyolojisi tam olarak bilinme- mektedir. Lezyonun cerrahi olarak uzaklaştırılması en çok uygulanan tedavi yöntemidir. Amacımız bu vakada santral dev hücreli granülomanın iliak greft ve hareketli yer tutucu aparey kullanılarak rehabili- tasyonunu rapor etmektir.

Vaka raporu: 10 yaşındaki erkek hasta kliniğimize mandibula anterior sol bölgede şişlik şikayetiyle başvurdu. Alınan anamnezde, şikayetin olduğu bölgeye yaklaşık 1 yıl önce cerrahi bir müdahale yapıldığı, fakat şişliğin altı ay önce tekrar oluştuğu öğrenildi. Genel anestezi altında lezyon çıkartıldı. Mandibular sol santral, lateral, kanin ve birinci premolar dişler çekildi. Mandibulada oluşan defekt iliak greftle onarıldı. Çıkarılan kitlenin histopatolojik incelemesi yapıldı ve santral dev hücreli granülom tanısı konuldu. Operasyon sonrası yapılan 12 aylık takipte herhangi bir problemle karşılaşılmadı. Daha sonra hastaya hareketli yer tutucu bir aparey yapıldı.

Sonuç: Literatürde santral dev hücreli granülom gibi agresif lezyonların %72 rekürens oranı olduğu görül- mektedir. Rekürens gösteren vakalarda kortikostreoid enjeksiyonu, sistemik kalsitonin uygulaması gibi konservatif yöntemlerin başarısı kesin değildir. Cerrahi tedavi çene kemiklerinde major defektlere neden ola- bilir ve fasiyal konturu bozabilir. Böyle bir durumda de- fektin iliak greftle tamiri estetik problemleri çözecektir ve protezle rehabilitasyon imkanı sunacaktır.

Keywords

• santral dev hücreli granüloma, iliak greft, hareketli yer tutucu

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