Implant-Associated Giant Cell Granuloma: A Case Report of 4.8-Year Follow-up and Literature Review.

Abstract

Objective. The aim of this case report was to document a case of implant associated central giant cell granuloma (CGCG) and review the literature on implant associated and intrabony lesions. CGCG is most common in females and usually seen in the mandible from anterior to posterior. Based on its clinical, radiological, and histological findings, it can be classified as aggressive and non-aggressive forms. Trauma is considered a major etiological factor for the lesion. Even peripheral giant cell granuloma has been shown as a peri-implant lesion, CGCG has not been reported as an implant-associated pathology. In this case report, we reported that CGCG developed after implant placement in 8 months. 39-year-old female patient with partial edentulism in the posterior mandible presented to our clinic. She had reported that she lost her posterior mandible teeth for more than six years. Initial clinical and radiological examination revealed that she showed localized slight to moderate chronic periodontitis, horizontal ridge deficiency (in the posterior mandible), and cavities. A total of six implants were placed at the same time. At 8-month of the surgery, she showed a radiolucency area #34 area. The lesion was enucleated, and the defect area was filled up with a xenogeneic bone substitute. The healing was uneventful. The histological examination determined the lesion was CGCG. The lesion showed no recurrency for 4.8 years.

Keywords

• mandible
• giant cell lesions
• dental implants

References

1. References: 1. Etoz M, Asantogrol F, Akyol R. Central giant cell granulomas of the jaws: retrospective radiographic analysis of 13 patients. Oral Radiol. 2020;36:60-68.
2. 2. Alsufyani NA, Aldosary RM, Alrasheed RS, Alsaif RF. A systematic review of the clinical and radiographic features of hybrid central giant cell granuloma lesions of the jaws. Acta Odontol Scand. 2021;79:124-131.
3. 3. de Lange J, van den Akker HP, van den Berg H. Central giant cell granuloma of the jaw: a review of the literature with emphasis on therapy options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:603-615.
4. 4. Jadu FM, Pharoah MJ, Lee L, Baker GI, Allidina A. Central giant cell granuloma of the mandibular condyle: a case report and review of the literature. Dentomaxillofac Radiol. 2011;40:60-64.
5. 5. Sun ZJ, Cai Y, Zwahlen RA, Zheng YF, Wang SP, Zhao YF. Central giant cell granuloma of the jaws: clinical and radiological evaluation of 22 cases. Skeletal Radiol. 2009;38:903-909.
6. 6. Heithersay GS, Cohn SA, Parkins DJ. Central giant cell granuloma. Aust Endod J. 2002;28:18-23.
7. 7. Chrcanovic BR, Gomes CC, Gomez RS. Central giant cell lesion of the jaws: An updated analysis of 2270 cases reported in the literature. J Oral Pathol Med. 2018;47:731-739.
8. 8. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. Periodontol 2000. 2004;34:9-21.

9. 9. Barone A, Crespi R, Aldini NN, Fini M, Giardino R, Covani U. Maxillary sinus augmentation: histologic and histomorphometric analysis. Int J Oral Maxillofac Implants. 2005;20:519-525.
10. 10. Andabak Rogulj A, Tomasovic Loncaric C, Muller D, et al. Solid malignant metastases in the jaw bones. Br J Oral Maxillofac Surg. 2018;56:705-708.
11. 11. Jaffe HL. Giant-cell reparative granuloma, traumatic bone cyst, and fibrous (fibro-oseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol. 1953;6:159-175.
12. 12. Zhang Q, He Z, Wang G, Jiang H. Radiotherapy for recurrent central Giant cell granuloma: a case report. Radiat Oncol. 2019;14:130.
13. 13. Murphey MD, Nomikos GC, Flemming DJ, Gannon FH, Temple HT, Kransdorf MJ. From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation. Radiographics. 2001;21:1283-1309.
14. 14. Dos Santos LA, Campos PS, Laranjeira AL, Bonan PR, Martelli H, Jr., Cardoso SV. Effectiveness of computed tomography to evaluate central giant cell lesion. Dentomaxillofac Radiol. 2007;36:522-525.
15. 15. Tarsitano A, Del Corso G, Pizzigallo A, Marchetti C. Aggressive Central Giant Cell Granuloma of the Mandible Treated With Conservative Surgical Enucleation and Interferon-α-2a: Complete Remission With Long-Term Follow-Up. J Oral Maxillofac Surg. 2015;73:2149-2154.
16. 16. Whitaker SB, Waldron CA. Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study. Oral Surg Oral Med Oral Pathol. 1993;75:199-208.
17. 17. Balaji P, Balaji SM. Central giant cell granuloma - A case report. Indian J Dent Res. 2019;30:130-132.
18. 18. Becker W, Clokie C, Sennerby L, Urist MR, Becker BE. Histologic findings after implantation and evaluation of different grafting materials and titanium micro screws into extraction sockets: case reports. J Periodontol. 1998;69:414-421.