Gómez-Ordoñez CD, Maya-García IA, Acuña-González GR, Sarmiento-Rebolledo LD, González-Domínguez SI

Language: Spanish
References: 18
Page: 2293-2298
PDF size: 325.80 Kb.

ABSTRACT

Introduction. Giant cell lesions represent a heterogeneous group of proliferation in multinucleated giant cells with lytic activity, immersed in a connective tissue stroma. Tumors constitute four to five percent of primary bone tumors, while granulomas are 9.29% of oral cavity lesions. Regarding its treatment, it is outlined based on clinical, radiographic and histological connotations, that diversify its management. Objective. To present a proposal of clinical decision-making tree in head and neck, useful to the general dentist. Case report. A case series of giant cell lesions is presented, detected between 2018 and 2023. They are common in men (m/w ratio of 3:2), located mostly in the lower jaw (upper/lower jaw ratio of 2:3), with bone loss with defined edges, unilocular or multilocular radiographic pattern, with variable evolution time depending on the case. All cases underwent incisional biopsy for histological study, which would delimit the surgical protocol to follow. According to a tree proposal for decision making. Discussion. Basically, it deals with the dilemma of aggressiveness with reference to the clinical, radiological, histological or molecular parameters that help determine its clinical behavior. So, when could one of these lesions be considered a tumor? The proposal of this work aims to provide a tree of suggestions for decision-making for management that guides the general dentist. Conclusions. According to the osteoclastic differentiation, count of the number of nuclei of multinucleated giant cells, systemic involvement associated with the PTH hormone, among others, the present report provides a management suggestion for these injuries based on the evidence. The general dentist must recognize the aspects: family, clinical, radiological, and histological aspects, to be able to differentiate a tumor lesio n from a giant cell granuloma.

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