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|Intra-lesional medicaments for the management of intra-osseous lesions of maxilla and mandible - systematic review
Komal Smriti1, Evit John2, Kalyana-Chakravarthy Pentapati3, Srikanth Gadicherla4, Manish Bhagania5
1 Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 MPH Candidate, School of Public Health, University of Texas Health Sciences Centre, Houston, Texas, USA
3 Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
4 Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
5 Oral and Maxillofacial Surgery, Boston University, Boston, MA, USA
|Date of Submission||17-Jul-2019|
|Date of Acceptance||21-Oct-2019|
|Date of Web Publication||24-Jan-2020|
Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka.
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aims and Objectives: This study aimed to review the success or remission of intralesional medicaments in the management of intraosseous lesions in the oral cavity. Materials and Methods: A comprehensive search was performed in two databases (PubMed and Scopus). Research articles, case reports, case series, and clinical trials were included. Review articles, lesions not involving the bone, incomplete reporting, any other treatment other than intralesional medicaments to treat intraosseous bone lesions, publications without any treatment, and letter to editor were excluded. Data on remission (complete, partial, or no remission), details and regimen of the intervention, number of participants, and follow-up in months were recorded. Results: A total of 653 publications were available for title and abstract screening after the removal of duplicates. Seven articles were excluded, which were not in English. After title and abstract screening, a total of 88 publications were available for full-text screening. Fifty-five articles were included in qualitative synthesis. A total of 168 patients from 55 publications were evaluated. Minimum follow-up was 1 month and maximum was 264 months. More than two-third (n = 38) of the publications were case reports on single patient. More than two-third (n = 38) of the publications had complete remission. Conclusion: Intralesional medications have shown variable success rates. Extensive lesions may undergo intralesional medications followed by surgical management.
Keywords: Aneurysmal bone cysts, giant cell granuloma, intralesional injections, langerhans cell histiocytosis, vascular malformation osseous
|How to cite this URL:|
Smriti K, John E, Pentapati KC, Gadicherla S, Bhagania M. Intra-lesional medicaments for the management of intra-osseous lesions of maxilla and mandible - systematic review. J Int Soc Prevent Communit Dent [Epub ahead of print] [cited 2021 Jan 20]. Available from: https://www.jispcd.org/preprintarticle.asp?id=276730
| Introduction|| |
The myriad pathological entities involving the mandible can be odontogenic or non-odontogenic in origin. Most of these lesions are treated surgically by curettage, resection, and so on, along with chemotherapy, radiation, or pharmaceutical management. In most cases, surgical intervention has proven to be a complete cure; however, recurrences have been reported by multiple authors for various diseases.
Moreover, for large lesions, surgical intervention may result in detrimental postoperative functional, aesthetic, or neurological outcomes. Hence, health-care professionals have tried pharmacological aids such as intralesional medications. Intralesional injections (ILIs) mean those injections with standard dosage, which are injected directly into a lesion on or immediately below the skin or mucosa.
Reports in the past have used intralesional steroids for the treatment of intraosseous lesions with different regimens. For example, central giant cell granuloma (CGCG) have been treated with intralesional steroids with different regimens viz., weekly, or biweekly;, different doses viz., 10 mg/mL,, 20 mg/mL,, or 40 mg/mL;, and different durations viz., 5 weeks, 6 weeks,, 9 weeks, and 11 weeks. There is no lack of consensus and mostly dictated by the clinician judgment and or radiological improvement in the subjects. Similarly, langerhans cell histiocytosis (LCH) of jaws has been treated with intralesional steroids with different regimens., However, these conditions have been predominantly treated by ILI of steroids.
There is lack of consensus with respect to the duration, frequency, dosage, criteria, or guideline for improvement for these intraosseous conditions. Also, majority of these publications are case reports and case series. With this background, we aimed to systematically review the existing literature on intralesional treatment of intraosseous lesion of the jaws and provide summary on remission, dosage, regimen, and follow-up.
| Materials and Methods|| |
A comprehensive search was performed in two databases (PubMed and Scopus) up to August 31, 2019 separately for each condition. The keywords included in the search strategy for all the databases are listed in [Table 1]. The studies from these databases were imported to Rayyan website for the removal of duplicate titles. The remaining articles had their title and abstracts screened (GS and KS) for inclusion in the full text review. Articles were subjected to full-text screening by two reviewers (PKC and GS). Discrepancies if any were resolved by third reviewer (MB). Research articles, case reports, case series, and clinical trials were included. The inclusion criteria were subjects of any age group and those treated with any of the established intralesional treatment protocols. The exclusion criteria were only review articles, lesions not involving the bone, incomplete reporting, any other treatment other than intralesional medicaments to treat intraosseous bone lesions, publications without any treatment, and letter to editor. Data on remission (complete, partial, or no remission), details and regimen of the intervention, number of participants, and maximal follow-up in months were recorded independently by two reviewers. No attempt was made to contact the authors for any additional data.
| Results|| |
A total of 233, 71, 149, and 37 publications were reported from PubMed for CGCG, central hemangioma, central vascular malformations (CVMs), aneurysmal bone cyst, and langerhan cell histiocytosis, respectively. Similarly, 226, 17, 147, and 5 publications were reported from Scopus for CGCG, central hemangioma or CVMs, aneurysmal bone cyst, and langerhan cell histiocytosis, respectively. Reference lists of articles were further searched to identify other articles that may have been missed during the respective database searches with the keywords (n = 17). A total of 653 publications were available for title and abstract screening after the removal of duplicates. Seven articles were excluded, which were not in English. After title and abstract screening, a total of 88 publications were available for full-text screening. Fifty-five articles were included in qualitative synthesis [Figure 1].
A total of 168 patients from 55 publications were evaluated. Minimum follow-up was 1 month and maximum was 264 months. The age ranged from 3 to 84 years. More than two-third (n = 38) of the publications were case reports on single patient. More than two-third (n = 38) of the publications had complete remission.
| Discussion|| |
CGCG was first introduced by Jaffe and described by WHO as an aggressive idiopathic benign intraosseous lesion that occurs almost exclusively in the jaws. Generally, this lesion is classified as either a nonaggressive and an aggressive form; the aggressive form is characterized by a size larger than 5cm, rapid growth, high recurrence, thinning and/or perforation of the bone, tooth mobility, rotation, and/or root resorption. Medical management of CGCG includes intralesional steroids, calcitonin, interferon-α, and bisphosphonates. However, only corticosteroids have been used as ILI.
ILI was first reported by Jacoway et al.; the rationale for its use was based on its histological similarity to sarcoid and with proven effect of corticosteroids on the treatment of the latter. Corticosteroids act by suppressing angiogenesis of the lesion and inhibiting bone resorption by inhibiting protease production from multinucleated giant cell and apoptosis of osteoclastic cells. The success of the ILI for the management of CGCG of various reports is listed in [Table 2]. A total of 34 publications have used intralesional steroids for the treatment of CGCG. Of which 22 publications have reported complete remission. Two complications with the use of ILI of corticosteroids have been reported such as central retinal artery occlusion resulting in blindness and cushinoid appearance of the patient.
|Table 2: Characteristics of the reports that used ILI for the management of CGCG|
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Studies in the past have used calcitonin in the treatment of CGCG through subcutaneous or intranasal routes.,,,,,, However, till date no studies have reported the treatment of CGCG with ILI of calcitonin. Limited case reports have been published on the use of subcutaneous injections of interferon-α as a treatment for aggressive CGCG with variable success rates.,,,, However, no studies have used ILI of interferon-α in the treatment of CGCG.
LCH is a disease characterized by cell proliferation with three clinical forms such as Letter–Siwe disease (acute disseminated form), Hand–Schüller–Christian syndrome (chronic disseminated form), and localized LCH (localized form) also known as eosinophilic granuloma.,, Treatment options include resection, curettage, chemotherapy, radiotherapy, or a combination of them. The principal modality is surgical curettage but is limited by the extent of the lesion, which, in the case of extensive lesions, may result in a loss of function and disfigurement.
A total of eight publications reported the treatment of LCH in 11 patients with intralesional steroids injections [Table 3]. All the publications showed complete remission with a minimum of 4 and maximum of 108 months’ follow-up.
|Table 3: Characteristics of the reports that used intralesional medications for the management of LCH|
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CVMs are categorized into low-flow lesions (such as lymphatic, venous, and capillary malformations) and high-flow lesions (such as AV malformations and AV fistula). Arterial vascular malformations (AVMs) are the most common malformations, and its occurrence in the maxillofacial region is frequently devoid of any signs or symptoms until they are extensive enough to cause pain, facial asymmetry, pressure on adjacent structures, auditory and visual problems, mandibular destruction, mobility of the tooth, and bleeding gums. They have a high propensity to bleed, which may be life-threatening.,,,
Treatment for such options is nonsurgical or surgical, with the former including intravascular embolization with/without sclerosants. Surgical correction is reserved because of its high propensity to bleed and is used for extensive lesions. Selective angiographic embolization is considered first-line treatment with/without surgical approach to contain the bleeding.
A total of nine publications reported the treatment of CVM in 54 patients [Table 4]. Majority of the publications showed complete remission (n = 7) with a minimum of 6 and maximum of 144 months’ follow-up.
|Table 4: Characteristics of the reports that used intralesional medications for the management of CVM|
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ABC is a benign cystic lesion of the bone comprising blood-filled spaces separated by connective tissue. It has a rapid growth pattern, which results in bony expansion and facial asymmetry. Treatment of an ABC is usually complete surgical removal of the lesion, along with surgical curettage or block resection. Because of its multilocular appearance and multiple bony septae, the chance of recurrence is high postsurgery. Surgical management, along with medical management, has been advised to reduce the risk of recurrence.
A total of four publications reported the treatment of ABC in 13 patients [Table 5]. Majority of the publications showed partial remission (n = 3) with a minimum of 4 and maximum of 108 months’ follow-up.
|Table 5: Characteristics of the reports that used intralesional medications for the management of aneurysmal bone cyst|
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Intraosseous lesions of the jaws were treated successfully by surgical intervention. However, conservative pharmaceutical therapies have been shown as successful as surgery with minimal complications. ILIs have shown variable success rates with or without requirement of surgery. Extensive lesions may undergo medical management followed by surgical management. Hence, health-care providers should consider various factors such as patient characteristics, frequency, dose and type of ILI medications, requirement of conservative or surgical or both modalities of treatment, complications that might arise because of the ILI and their management, and presence of any comorbidities that may have a role in successful management of these lesions. Most of these factors are interlinked and may require modification or alternate strategies for effective management of these lesions.
| Limitations and Future Scope|| |
Most of the publications included in this systematic review were case reports and case series, which limited us to perform meta-analysis. There was no consensus definition among the included publications about the remission or success of the treatment of various lesions using intralesional medications. The success or remission of these lesions was reported in these publications as anatomical cure, clinical cure, and radiological cure, which could create ambiguity to the researchers and clinicians. A uniform consensus on the definition of success or remission should be followed. Future reports should include the patient reported outcomes of the same as one of the parameters for success. Future reports should also include radiological assessment and quantification of the improvement with the treatment.
| Conclusion|| |
Most intraosseous lesions of the jaws were treated successfully by surgical intervention. Several conservative pharmaceutical therapies have been shown as successful as surgery with minimal complications. For the above-discussed intraosseous lesions, ILIs have shown variable success rates with or without requirement of surgery. Extensive lesions may undergo medical management followed by surgical management.
Search strategy for PubMed
((((central AND giant AND cell AND granuloma)) AND (Management OR Treatment))) AND (Maxilla OR Mandible OR Jaws)
((((((Central Hemangioma OR Central Vascular malformations)) AND (Management OR Treatment))) AND (Maxilla OR Mandible OR Jaws)))
(((((Aneurysmal bone cyst)) AND (Management OR Treatment))) AND (Maxilla OR Mandible OR Jaws))
((((((Langerhan cell histiocytosis)) AND (Management OR Treatment))) AND (Maxilla OR Mandible OR Jaws)))
Search strategy for Scopus:
(TITLE-ABS-KEY (central AND giant AND cell AND granuloma) AND TITLE-ABS-KEY (management OR treatment) AND TITLE-ABS-KEY (maxilla OR mandible OR jaws))
(TITLE-ABS-KEY (central AND hemangioma OR central AND vascular AND malformations) AND TITLE-ABS-KEY (management OR treatment) AND TITLE-ABS-KEY (maxilla OR mandible OR jaws))
(TITLE-ABS-KEY (aneurysmal AND bone AND cyst) AND TITLE-ABS-KEY (management OR treatment) AND TITLE-ABS-KEY (maxilla OR mandible OR jaws))
(TITLE-ABS-KEY (langerhan AND cell AND histiocytosis) AND TITLE-ABS-KEY (management OR treatment) AND TITLE-ABS-KEY (maxilla OR mandible OR jaws))
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
Komal Smriti: study conception, data collection, initial draft
Evit John: study conception, data collection, data acquisition and analysis, initial draft
Kalyana-Chakravarthy Pentapati: Data acquisition and analysis, data interpretation, final draft
Srikanth Gadicherla: Study conception, Data acquisition and analysis, data interpretation, final draft
Manish Bhagania: Data collection, data acquisition and analysis, data interpretation, final draft
All the authors approved the final version of the manuscript for publication.
Ethical Policy and Institutional Review Board Statement
Patient Declaration of Consent
Data Availability Statement
Data set can be made available on request from (Dr Srikanth G, [email protected]).
| References|| |
Ogle OE, Santosh ABR. Medication management of jaw lesions for dental patients. Dent Clin North Am 2016;60:483-95.
Mohanty S, Jhamb A. Central giant cell lesion of mandible managed by intralesional triamcinolone injections: A report of two cases and literature review. Med Oral Patol Oral Cir Bucal 2009;14:E98-102.
Wendt FP, Torriani MA, Gomes AP, de Araujo LM, Torriani DD. Intralesional corticosteroid injection for central giant cell granuloma: an alternative treatment for children. J Dent Child (Chic) 2009;76:229-32.
Batista Severo ML, Lopes MLDS, Miguel MCDC, Germano AR, Nogueira RLM, Turatti E, et al
. Immunoexpression of calcitonin and glucocorticoid receptors in central giant cell lesions of the jaws. J Oral Pathol Med 2018;47:907-13.
Nogueira RL, Teixeira RC, Cavalcante RB, Ribeiro RA, Rabenhosrt SH. Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant-cell granuloma in 21 cases. Int J Oral Maxillofac Surg 2010;39:1204-10.
El Hadidi YN, Ghanem AA, Helmy I. Injection of steroids intralesional in central giant cell granuloma cases (giant cell tumor): Is it free of systemic complications or not? A case report. Int J Surg Case Rep 2015;8C:166-70.
Rachmiel A, Emodi O, Sabo E, Aizenbud D, Peled M. Combined treatment of aggressive central giant cell granuloma in the lower jaw. J Craniomaxillofac Surg 2012;40:292-7.
Shirani G, Abbasi AJ, Mohebbi SZ, Shirinbak I. Management of a locally invasive central giant cell granuloma (CGCG) of mandible: Report of an extraordinary large case. J Craniomaxillofac Surg 2011;39:530-3.
Ferretti C, Muthray E. Management of central giant cell granuloma of mandible using intralesional corticosteroids: Case report and review of literature. J Oral Maxillofac Surg 2011;69:2824-9.
Khafif A, Krempl G, Medina JE. Treatment of giant cell granuloma of the maxilla with intralesional injection of steroids. Head Neck 2000;22:822-5.
Rajeevan NS, Soumithran CS. Intralesional corticosteroid injection for central giant cell granuloma: A case report. Int J Oral Maxillofac Surg 1998;27:303-4.
Esen A, Dolanmaz D, Kalayci A, Günhan O, Avunduk MC. Treatment of localized langerhans’ cell histiocytosis of the mandible with intralesional steroid injection: Report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e53-8.
Moralis A, Kunkel M, Kleinsasser N, Müller-Richter U, Reichert TE, Driemel O. Intralesional corticosteroid therapy for mandibular langerhans cell histiocytosis preserving the intralesional tooth germ. Oral Maxillofac Surg 2008;12:105-11.
Jaffe HL. Giant-cell reparative granuloma, traumatic bone cyst, and fibrous (fibro-oseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol 1953;6:159-75.
WHO. World Health Organization IARC ScreeningGroup. WHO Histological Classification of Odontogenic Tumors. Bone-related Lesions. WHO: Central Giant Cell Lesion (Granuloma).
Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A. Central giant cell lesions of the jaws: A clinicopathologic study. J Oral Maxillofac Surg 1986;44:708-13.
Terry B, Jacoway J. Management of central giant cell lesion: An alternative to surgical therapy. Oral Maxillofac Surg Clin North Am 1994;6:579-600.
Vered M, Buchner A, Dayan D. Central giant cell granuloma of the jawbones–new insights into molecular biology with clinical implications on treatment approaches. Histol Histopathol 2008;23:1151-60.
Bhushan G, Gupta S, Bhushan U, Raina UK. Central retinal artery occlusion as an iatrogenic complication of treatment of central giant cell granuloma of the mandible. J Oral Maxillofac Surg 2015;73:933.e1-6.
Kermer C, Millesi W, Watzke IM. Local injection of corticosteroids for central giant cell granuloma: A case report. Int J Oral Maxillofac Surg 1994;23:366-8.
Kurtz M, Mesa M, Alberto P. Treatment of a central giant cell lesion of the mandible with intralesional glucocorticosteroids. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:636-7.
Adornato MC, Paticoff KA. Intralesional corticosteroid injection for treatment of central giant-cell granuloma. J Am Dent Assoc 2001;132:186-90.
Carlos R, Sedano HO. Intralesional corticosteroids as an alternative treatment for central giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:161-6.
Abdo EN, Alves LC, Rodrigues AS, Mesquita RA, Gomez RS. Treatment of a central giant cell granuloma with intralesional corticosteroid. Br J Oral Maxillofac Surg 2005;43:74-6.
Sezer B, Koyuncu B, Gomel M, Günbay T. Intralesional corticosteroid injection for central giant cell granuloma: A case report and review of the literature. Turk J Pediatr 2005;47:75-81.
Oliveira AC, de Moraes Ramos FM, Jeunon FA, Silva EC, Manzi FR. Central haemangioma of the mandible in a 7-year old child. Int J Paediatr Dent 2009;19:216-8.
da Silva NG, Carreira AS, Pedreira EN, Tuji FM, Ortega KL, de Jesus Viana Pinheiro J. Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections. Head Face Med 2012;8:23.
da Silva Sampieri MB, Yaedú RY, Santos PS, Gonçales ES, Santa’ana E, Consolaro A, et al
. Central giant cell granuloma: Treatment with calcitonin, triamcinolone acetonide, and a cystic finding 3 years and 6 months after the primary treatment. Oral Maxillofac Surg 2013;17:229-34.
Fonseca FP, Ribeiro AC, Santos-Silva AR, Vargas PA, Lopes MA. Fine needle aspiration cytology and intralesional steroid injection in a central giant cell granuloma affecting the gingiva: A new clinical approach. Braz Dent J 2013;24:420-7.
Özlem Filiz B, Gülsüm AK. Treatment of giant cell granuloma with intralesional corticosteroid injections: A case report. J Istanb Univ Fac Dent 2015;49:45-50.
Gupta B, Stanton N, Coleman H, White C, Singh J. A novel approach to the management of a central giant cell granuloma with denosumab: A case report and review of current treatments. J Craniomaxillofac Surg 2015;43:1127-32.
Pakla P, Wojnar J, Lewandowski B. Central Giant Cell Lesion of the Maxilla. Case Study. J Stomatol 2015;68:476-84.
Maia Nogueira RL, Osterne RL, Cavalcante RB, Abreu RT. Surgical treatment, oral rehabilitation, and orthognathic surgery after failure of pharmacologic treatment of central giant cell lesion: A case report. J Oral Maxillofac Surg 2016;74:2567.e1-e10.
Dolanmaz D, Esen A, Mihmanlı A, Işık K. Management of central giant cell granuloma of the jaws with intralesional steroid injection and review of the literature. Oral Maxillofac Surg 2016;20:203-9.
Chandna P, Srivastava N, Bansal V, Wadhwan V, Dubey P. Peripheral and central giant cell lesions in children: Institutional experience at subharti dental college and hospital. Indian J Med Paediatr Oncol 2017;38:440-6.
] [Full text]
de Oliveira JP, Olivete F, de Oliveira ND, Giovanini AF, Zielak JC, Klüppel L, et al
. Combination therapies for the treatment of recurrent central giant cell lesion in the maxilla: A case report. J Med Case Rep 2017;11:74.
da Rosa MRP, de Sá JL, Martins VB, de Oliveira MV. Central giant cells lesion: Report of a conservative management. Eur J Dent 2018;12:305-10.
Moura LB, Tarquinio SBC, Gomes APN, Schinestsck AR, Torriani MA. Modified approach to central giant cell lesion. J Clin Pediatr Dent 2018;42:292-4.
Cavalcante IL, Barros CCS, Rodrigues KAM, Osterne RLV, Cavalcante RB, Nogueira RM,et al
. Quantification of bone gain in central giant cell granuloma of the jaws submitted to intralesional corticotherapy. J Bras Patol e Med Lab2018;54:183-8.
de Mendonça RP, Mitre GP, Real FH, da Silva Kataoka MS, de Melo Alves Júnior S, Vianna P, et al
. Central giant cell granuloma treated with intralesional corticosteroid injections and bisphosphonates: a long-term follow-up case study. Head Neck Pathol2019. doi: 10.1007/s12105-019-01053-x. [Epub ahead of print].
Harris M. Central giant cell granulomas of the jaws regress with calcitonin therapy. Br J Oral Maxillofac Surg 1993;31:89-94.
Pogrel MA, Regezi JA, Harris ST, Goldring SR. Calcitonin treatment for central giant cell granulomas of the mandible: Report of two cases. J Oral Maxillofac Surg 1999;57:848-53.
Pogrel MA. Calcitonin therapy for central giant cell granuloma. J Oral Maxillofac Surg 2003;61:649-53; discussion 53-4.
O’Regan EM, Gibb DH, Odell EW. Rapid growth of giant cell granuloma in pregnancy treated with calcitonin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:532-8.
de Lange J, Rosenberg AJ, van den Akker HP, Koole R, Wirds JJ, van den Berg H. Treatment of central giant cell granuloma of the jaw with calcitonin. Int J Oral Maxillofac Surg 1999;28:372-6.
de Lange J, van den Akker HP, Veldhuijzen van Zanten GO, Engelshove HA, van den Berg H, Klip H. Calcitonin therapy in central giant cell granuloma of the jaw: A randomized double-blind placebo-controlled study. Int J Oral Maxillofac Surg 2006;35:791-5.
Dominguez CL, Martinez GC, Plasencia DJSM. Intranasal calcitonin therapy for central giant cell granuloma. J Cran Maxillofac Surg 2004;32:244-5.
Collins A. Experience with anti-angiogenic therapy of giant cell granuloma of the facial bones. Ann R Australas Coll Dent Surg 2000;15:170-5.
Busaidy B, Wong MEK, Herzog C, Flaitz C, Marchena J, Eftekhari F. Alpha interferon in the management of central giant cell granuloma: early experiences. Journal of Oral and Maxillofacial Surgery 2002;60:86-7 .
Goldman KE, Marshall MK, Alessandrini E, Bernstein ML. Complications of alpha-interferon therapy for aggressive central giant cell lesion of the maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:285-91.
de Lange J, van den Akker HP, van den Berg H, Richel DJ, Gortzak RA. Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy: A report of 2 cases. Int J Oral Maxillofac Surg 2006;35:865-9.
Kaban LB, Troulis MJ, Wilkinson MS, Wilkinson MJ, Ebb D, Dodson TB. Adjuvant antiangiogenic therapy for giant cell tumors of the jaws. J Oral Maxillofac Surg 2007;65:2018-24; discussion 2024.
Komp DM. Langerhans cell histiocytosis. N Engl J Med 1987;316:747-8.
Lichtenstein L. Histiocytosis X: Integration of eosinophilic granuloma of bone, letterer-siwe disease, and schüller-christian disease as related manifestations of a single nosologic entity. AMA Arch Pathol 1953;56:84-102.
Miloro M, Ghali GE, Larsen PWP. Peterson’s principles of oral and maxillofacial surgery.
Nauert C, Zornoza J, Ayala A, Harle TS. Eosinophilic granuloma of bone: Diagnosis and management. Skeletal Radiol 1983;10:227-35.
Cohen M, Zornoza J, Cangir A, Murray JA, Wallace S. Direct injection of methylprednisolone sodium succinate in the treatment of solitary eosinophilic granuloma of bone: A report of 9 cases. Radiology 1980;136:289-93.
Jones LR, Toth BB, Cangir A. Treatment for solitary eosinophilic granuloma of the mandible by steroid injection: Report of a case. J Oral Maxillofac Surg 1989;47:306-9.
Watzke IM, Millesi W, Kermer C, Gisslinger H. Multifocal eosinophilic granuloma of the jaw: Long-term follow-up of a novel intraosseous corticoid treatment for recalcitrant lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:317-22.
Putters TF, de Visscher JG, van Veen A, Spijkervet FK. Intralesional infiltration of corticosteroids in the treatment of localised langerhans’ cell histiocytosis of the mandible report of known cases and three new cases. Int J Oral Maxillofac Surg 2005;34:571-5.
Lee SH, Yoon HJ. Intralesional infiltration of corticosteroids in the treatment of localized langerhans cell histiocytosis of the mandible: Report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116:e255-60.
Hutchison A, Jain S, Hyam D, Dahlstrom JE. Tennis racquets in the jaw: Eosinophilic granuloma. Pathology 2012;44:387.
Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: A classification based on endothelial characteristics. Plast Reconstr Surg 1982;69:412-22.
Burrows PE, Mulliken JB, Fellows KE, Strand RD. Childhood hemangiomas and vascular malformations: Angiographic differentiation. AJR Am J Roentgenol 1983;141:483-8.
Lam SM, Dahiya R, Williams EF 3rd. Management of an arteriovenous malformation. Arch Facial Plast Surg 2003;5:334-7.
Watzinger F, Gössweiner S, Wagner A, Richling B, Millesi-Schobel G, Hollmann K. Extensive facial vascular malformations and haemangiomas: A review of the literature and case reports. J Craniomaxillofac Surg 1997;25:335-43.
Thorn JJ, Worsaae N, Gyldensted C. Arterial embolisation in the treatment of central haemangiomas of the maxilla: Report of two cases. Br J Oral Maxillofac Surg 1986;24:114-21.
Shultz RE, Richardson DD, Kempf KK, Pevsner PH, George ED. Treatment of a central arteriovenous malformation of the mandible with cyanoacrylate: A 4-year follow-up. Oral Surg Oral Med Oral Pathol 1988;65:267-71.
Kaneko R, Tohnai I, Ueda M, Negoro M, Yoshida J, Yamada Y. Curative treatment of central hemangioma in the mandible by direct puncture and embolisation with n-butyl-cyanoacrylate (NBCA). Oral Oncol 2001;37:605-8.
Persky MS, Yoo HJ, Berenstein A. Management of vascular malformations of the mandible and maxilla. Laryngoscope 2003;113:1885-92.
Liu D, Ma X, Zhao F, Zhang J. Intraosseous embolotherapy of central arteriovenous malformations in the jaw: Long-term experience with 8 cases. J Oral Maxillofac Surg 2009;67:2380-7.
Guibaud L, Herbreteau D, Dubois J, Stempfle N, Bérard J, Pracros JP, et al
. Aneurysmal bone cysts: Percutaneous embolization with an alcoholic solution of zein–series of 18 cases. Radiology 1998;208:369-73.
Dubois J, Chigot V, Grimard G, Isler M, Garel L. Sclerotherapy in aneurysmal bone cysts in children: A review of 17 cases. Pediatr Radiol 2003;33:365-72.
Kumar VV, Malik NA, Kumar DB. Treatment of large recurrent aneurysmal bone cysts of mandible: Transosseous intralesional embolization as an adjunct to resection. Int J Oral Maxillofac Surg 2009;38:671-6.
Costa de Freitas RM, Fonseca KC, Procópio RJ, Cardoso Lehman LF. Image-guided injection of bone allograft and autologous bone marrow for the treatment of aneurysmal bone cyst of the jaw. J Vasc Interv Radiol 2017;28:1299-1302.e2.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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