Peripheral giant cell granuloma

  • 文章类型: Journal Article
    外周巨细胞肉芽肿(PGCG)是口腔中的一种反应性增生性病变,由于局部刺激或慢性创伤而发展,起源于骨膜或牙周膜。它主要影响下颌后区的肺泡粘膜,并且在四到六十年的年龄范围内发病率最高,2:1的女性偏好。该研究的目的是分析周围巨细胞肉芽肿的组织病理学模式。
    这项回顾性研究是在获得所需的机构伦理委员会批准(SMC/UECM/2023/627/296)后,于2018年至2023年在三级护理教学医院进行的。纳入所有涉及/报告并符合设定的纳入和排除标准的颌面部病变病例。通过计算变量的百分比来分析数据。使用IBMSPSS版本20软件来分析描述性数据。
    在12名患者中,四个是男性,八个是女性。年龄在20至60岁之间,平均年龄为40岁。纳入研究的所有患者都表现出多核巨细胞和炎症细胞,83.3%显示纤维基质,50%显示对角质化和铁黄素色素。
    PGCG,修复性病变,似乎主要发生在40-60年的生活与女性好感和常见的组织病理学特征包括多核巨细胞,所有病例中的炎症细胞,83.3%的纤维基质和50%的对角质化和铁黄素色素。
    UNASSIGNED: Peripheral giant cell granuloma (PGCG) is a type of reactive hyperplastic lesion in the oral cavity that develops due to local irritation or chronic trauma, originating from the periosteum or periodontal membrane. It primarily affects the alveolar mucosa of the posterior mandibular region and has a peak incidence in the age range of the fourth to sixth decades of life, with a 2:1 female predilection. The aim of the study was to analyse the histopathological pattern of peripheral giant cell granuloma.
    UNASSIGNED: This retrospective study was conducted at a tertiary care teaching hospital from 2018 to 2023 after obtaining the required institutional ethical board approval (SMC/UECM/2023/627/296). All the cases of maxillofacial lesions referred/reported to and which conformed to the set inclusion and exclusion criteria were included. Data were analysed by calculating the percentage of the variables. IBM SPSS version 20 software was used to analyse the descriptive data.
    UNASSIGNED: Out of 12 patients, four were males and eight were females. The age ranged from 20 to 60 years with an average age of 40 years. All the patients included in the study showed multinucleated giant cells and inflammatory cells, 83.3% showed fibrous stroma and 50% showed para-keratinisation and haemosiderin pigments.
    UNASSIGNED: PGCG, a reparative lesion, seems to occur mostly in the 40-60 years of life with female predilection and commonly seen histopathological features included multinuclear giant cells, inflammatory cells in all cases, 83.3% fibrous stroma and 50% both para-keratinisation and haemosiderin pigments.
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  • 文章类型: Case Reports
    背景:外植体-外胚层发育不良-唇腭裂(EEC)综合征主要影响外胚层和中胚层组织。它通常表现为分开的手和脚,外胚层发育不良,和口面裂开,以及其他症状和体征。需要多学科的治疗方法,其中牙医在识别和治疗可能与EEC综合征遗传相关或可能是EEC综合征的各种口腔疾病方面发挥重要作用。
    方法:本案例描述了一名患有EEC综合征并在下颌前区表现为周围巨细胞肉芽肿(PGCG)的幼儿的口腔状况。在获得全面的病史和家族史以及临床检查后,在局部麻醉下手术切除病灶.在接下来的二十四个月中,定期对患者进行随访,在此期间未观察到病变复发。
    结论:本报告强调了牙医在治疗EEC综合征患者口腔疾病中的作用。
    BACKGROUND: Ectrodactyly-ectodermal dysplasia-cleft lip/palate (EEC) syndrome mainly affects ectodermal and mesodermal tissues. It is usually manifested as split hands and feet, ectodermal dysplasia, and orofacial clefting, along with other signs and symptoms. A multidisciplinary approach to treatment is required, in which dentists play an important role in identifying and treating various oral conditions that may be genetically linked to or may be the result of EEC syndrome.
    METHODS: The present case describes the oral condition of a young child suffering from EEC syndrome and presenting with peripheral giant cell granuloma (PGCG) in the mandibular anterior region. After obtaining a thorough medical and family history and a clinical examination, the lesion was surgically excised under local anesthesia. The patient was followed up at periodic intervals for the next twenty four months, during which no recurrence of the lesion was observed.
    CONCLUSIONS: This report highlights the role of a dentist in the management of the oral conditions of patients suffering from EEC syndrome.
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  • 文章类型: Journal Article
    目的:牙龈是牙齿周围的支持组织之一,可受到各种肿瘤或非肿瘤性病变的影响。以前的研究已经检查了几种类型的牙龈病变,但是缺乏标准化的分类系统阻碍了有意义的比较。此外,许多研究主要集中在反应性病变上。我们的研究旨在通过调查不同年龄段的牙龈病变的患病率来促进对牙龈病变的理解。性别,网站,以及他们的临床表现。这项研究可以提高诊断准确性和治疗策略。
    方法:这项回顾性研究基于22年的活检来探讨牙龈病变的患病率。病人的人口统计细节,包括年龄,性别,系统收集病变的临床表现。这些病变分为六组。描述性统计,独立性的χ2检验,和单因素方差分析用于数据分析。
    结果:在7668个活检病灶中,684(8.9%)病变位于牙龈,女性发生率更高(63.5%)。软组织肿瘤是牙龈病变中最常见的组(72.1%),周围巨细胞肉芽肿(PGCG)是最常见的病变(21.2%),其次是,化脓性肉芽肿(19.3%),周围骨化性纤维瘤(17.8%)和局灶性纤维增生(7.6%);所有这些主要影响女性,平均年龄在生命的第四个十年下降。鳞状细胞癌被认为是最常见的恶性肿瘤。
    结论:在这项研究中,PGCG被发现是伊朗人群牙龈中最常见的病变。需要使用一致分类的进一步分析来确认这些结果。
    OBJECTIVE: Gingiva is one of the supporting tissues around the teeth that can be affected by various neoplastic or nonneoplastic lesions. Previous studies have examined several types of gingival lesions, but the lack of a standardized classification system has hindered meaningful comparisons. Additionally, many studies focused primarily on reactive lesions. Our study aims to contribute to the understanding of gingival lesions by investigating their prevalence across age groups, genders, sites, and by their clinical presentation. This research could lead to improved diagnostic accuracy and treatment strategies.
    METHODS: This retrospective study explores the prevalence of gingival lesions based on biopsies during a 22-year span. The patient\'s demographic details, including age, gender, and lesion\'s clinical presentation were systematically collected. These lesions were categorized into six groups. Descriptive statistics, χ2 test of independence, and one-way ANOVA were used for data analysis.
    RESULTS: Among the 7668 biopsied lesions, 684 (8.9%) lesions were located in the gingiva, with a greater occurrence in women (63.5%). Soft tissue tumors represented the most prevalent group in the gingival lesions (72.1%), and peripheral giant cell granuloma (PGCG) was the most frequent lesion (21.2%), followed by, pyogenic granuloma (19.3%), peripheral ossifying fibroma (17.8%) and focal fibrous hyperplasia (7.6%); all of which predominantly affected women, with mean ages falling in the fourth decade of life. Squamous cell carcinoma was recognized as the most common malignancy.
    CONCLUSIONS: In this study, PGCG was found to be the most common lesion in the gingiva in Iranian population. Further analysis using a unanimous categorization is required to confirm these results.
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  • 文章类型: Journal Article
    外周巨细胞肉芽肿(PGCG)是一种非肿瘤性,肿瘤样反应性病变,仅涉及牙龈和/或肺泡c。手术刀的手术方法一直是PGCG治疗的金标准,但科学文献报道的病变复发率很高。因此,这个独特的病例报告旨在评估λ10,600nm高水平激光治疗(HLLT)在根除持续性,侵略性,和对标准手术治疗无效的复发性PGCG。一名健康健康的34岁白种人男性,有两个月的口腔粘膜病变复发史,涉及右下第二前磨牙(LR5)和右下第一磨牙(LR6)之间的口腔和舌侧牙间乳头,之前用手术刀手术切除了三次。选择λ10,600nm诱导的HLLT作为1.62W的较低峰值功率的治疗模式,用功率计测量,在门控发射模式下发射(50%占空比),由此到达目标组织的平均输出功率为0.81W。斑点尺寸为0.8mm。90秒是总的治疗时间,总能量密度为7934.78J/cm2。患者自我报告结果显示,术后并发症很少或没有。在激光治疗后的第4天观察到初始愈合,术后2周完全愈合.组织学分析显示PGCG。这项独特的病例报告研究证明了λ10,600nm诱导的HLLT的疗效及其在根除持续性侵袭性PGCG方面优于标准手术方法,且术后并发症最少甚至没有。在6个月的随访时间点,加速伤口愈合超过生理愈合时间,没有PGCG复发的证据。基于这项独特研究的重要发现和我们以前的临床研究结果,我们可以确认我们的标准化λ10,600nm激光剂量测定诱导的HLLT和治疗方案在实现最佳结果方面的有效性和有效性。有必要进行随机对照临床试验,并在长期随访时间点将λ10,600nm与我们的剂量测定方案与标准手术治疗方式进行比较。
    Peripheral giant cell granuloma (PGCG) is a non-neoplastic, tumour-like reactive lesion that exclusively involves the gingiva and/or the alveolar crest. The surgical approach with a scalpel has been the golden standard of treatment for PGCG, but the scientific literature reports a high rate of lesion recurrence. Hence, this unique case report aimed to evaluate the efficacy of λ 10,600 nm high-level laser therapy (HLLT) in eradicating persistent, aggressive, and recurrent PGCG that failed to respond to standard surgical treatment. A fit and healthy thirty-four-year-old Caucasian male presented with a two-month history of recurrent episodes of an oral mucosal lesion involving the buccal and lingual interdental papillae between the lower right second premolar (LR5) and lower right first molar (LR6), which was surgically excised with a scalpel three times previously. A λ 10,600 nm-induced HLLT was chosen as a treatment modality at a lower peak power of 1.62 W, measured with a power metre, emitted in gated emission mode (50% duty cycle), whereby the average output power reaching the target tissue was 0.81 W. The spot size was 0.8 mm. Ninety seconds was the total treatment duration, and the total energy density was 7934.78 J/cm2. Patient self-reporting outcomes revealed minimal to no post-operative complications. Initial healing was observed on the 4th day of the post-laser treatment, and a complete healing occurred at two-weeks post-operatively. The histological analysis revealed PGCG. This unique case report study demonstrated the efficacy of λ 10,600 nm-induced HLLT and its superiority to eradicate persistent aggressive PGCG over the standard surgical approach with minimal to no post-operative complications, accelerating wound healing beyond the physiological healing time associated with no evidence of PGCG recurrence at the six-month follow-up timepoint. Based on the significant findings of this unique study and the results of our previous clinical studies, we can confirm the validity and effectiveness of our standardised λ 10,600 nm laser dosimetry-induced HLLT and treatment protocol in achieving optimal outcomes. Randomised controlled clinical trials with large data comparing λ 10,600 nm with our dosimetry protocol to the standard surgical treatment modality at long follow-up timepoints are warranted.
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  • 文章类型: Case Reports
    周围巨细胞肉芽肿(PGCG)是一种良性反应性外生性口腔病变,起源于骨膜或牙周膜。它仅在牙龈或肺泡粘膜上发育。甲状旁腺功能亢进(HPT)是其发展的可能病因。HPT是一种内分泌紊乱,其特征在于甲状旁腺激素(PTH)的分泌增加。此病例报告描述了一例在临床旁评估后诊断为继发性HPT的患者中复发性PGCG的病例。
    Peripheral giant cell granuloma (PGCG) is a benign reactive exophytic oral lesion that originates from the periosteum or the periodontal ligament. It exclusively develops on the gingiva or alveolar mucosa. Hyperparathyroidism (HPT) is a possible etiology for its development. HPT is an endocrine disorder characterized by increased secretion of the parathyroid hormone (PTH). This case report describes a case of recurring PGCG in a patient diagnosed with secondary HPT after paraclinical assessment.
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  • 文章类型: Case Reports
    外周巨细胞肉芽肿(PGCG)被描述为一种升高的病变,主要位于牙龈粘膜和牙槽骨上。连续刺激因素和创伤。它主要发生在下颌骨而不是上颌骨,通常在第4至第6个十年中看到。该病变的临床表现为红色-蓝色,呈现出与肝脏中观察到的相似的组织,通常测量小于2厘米。PGCG的治疗是手术切除。这种病变的复发在文献中很少描述。本病例强调了将创伤性摘除术视为主要不常见病因之一的重要性,导致周围巨细胞肉芽肿的发展。它准确地描述了诊断,位于上颌尖牙前磨牙区的周围巨细胞肉芽肿的治疗,自1年以来,在13和14的古代创伤摘除后连续发生。本文还报道了上颌骨位置的巨细胞肉芽肿,而文献报道更常见的是下颌位置。这个病灶是手术切除的,并最终治愈,随访中没有任何复发的迹象。
    Peripheral giant cell granuloma (PGCG) is described as an elevated lesion that is located mostly on the gingival mucosa and alveolar crest, consecutive to irritative factors and trauma. It predominantly occurs more in the mandible than the maxilla, and it is usually seen in the 4th to the 6th decades. The clinical appearance of this lesion is red-bluish in color, presenting a similar tissue to the one observed in the liver, usually measuring less than 2 cm. The treatment of the PGCG is the surgical excision. The recurrence of this lesion is rarely described in the literature. The present case highlights the importance of considering the traumatic extractions as one of the main uncommon etiologic factors, leading to the development of peripheral giant cell granuloma. It precisely describes the diagnosis, the treatment of a peripheral giant cell granuloma located in maxillary canine-premolar region, occurred consecutively after ancient traumatic extractions of the 13 and 14 since 1 year. This paper also reports a maxillary location of giant cell granuloma, while the literature reports more commonly the mandibular location. This lesion was excised surgically, and healed uneventually, and in which the follow-up didn´t show any sign of recurrence.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    巨细胞上皮(外周巨细胞肉芽肿)通常表现为局部刺激或慢性创伤后口腔区域的反应性良性病变。在这里,我们描述了一名45岁的男性患者的情况,该患者主诉是上颌骨前外侧有大量牙龈肿块。在过去的几个月里一直在逐步增长,咀嚼期间无痛不适感增加。患者还报告在齿间清洁期间出血。全面的体格检查导致怀疑巨细胞上皮以及其他差异,包括粘膜血管瘤和鳞状细胞癌,具有不显著的实验室价值。包括计算机断层扫描在内的影像学检查显示,先前在病变的任一侧插入了金属植入物以及粘膜增生的迹象。进行了证实的活检,显示基质反应床上有多个巨细胞,符合巨细胞外皮的诊断.口腔炎症条件,如巨细胞上皮有更大的机会局部复发,因此,仔细调查,及时准确诊断,对于适当的早期治疗至关重要。然后应采用完全手术切除以防止复发,因为不完全切除可能导致进一步复发。在治疗患者时,还应考虑识别和根除潜在的刺激源,以避免进一步复发。
    Giant cell epulis (peripheral giant cell granuloma) typically appears as a reactive benign lesion in the oral cavity in areas following local irritation or chronic trauma. Here we describe the case of a 45-year-old male patient who presented with the chief complaint of a large gingival mass in the anterolateral maxilla. There had been progressive growth within the past few months, with increased painless discomfort during mastication. The patient also reported bleeding during interdental cleaning. A full physical work-up led to the suspicion of giant cell epulis alongside other differentials including mucosal hemangioma and squamous cell carcinoma, with unremarkable laboratory values. Imaging including computed tomography showed signs of previous insertion of metal implants on either side of the lesion alongside mucosal hyperplasia. A confirmatory biopsy was taken and showed multiple giant cells on a reactive bed of stroma, in line with the diagnosis of giant cell epulis. Oral inflammatory conditions such as giant cell epulis have greater chances of local recurrence and, therefore, careful investigation with timely and accurate diagnosis is imperative for appropriate early treatment. Complete surgical excision should then be employed to prevent relapses, as incomplete removal can lead to further recurrence. Identification and eradication of potential sources of irritation should also be considered when treating the patient, to avoid further recurrence.
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  • 文章类型: Journal Article
    The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It\'s important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants.
    An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords \"Granuloma\" OR \"Granuloma, Giant Cell\" OR \"peripheral giant cell\" OR \"Granuloma, Pyogenic\" AND \"Dental implants\" OR \"Oral implants\".
    After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67).
    The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.
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  • 文章类型: Case Reports
    Peripheral giant cell granuloma (PGCG) known as \"giant cell epulis\" is a benign, reactive exophytic gingival lesion that accounts for less than 10% of all gingival lesions. PGCG affects females more than males with middle age predilection. Till now the etiology of PGCG remains unclear but various factors that can cause PGCG include poor oral hygiene, food impaction, following an extraction, dry mouth, hormonal disturbance, and hyperparathyroidism. The reported recurrence rate of the lesion is 5.0%-70.6%. The present case report describes the rare case of PGCG with primary hyperparathyroidism in a male patient with a history of swelling in the mandibular anterior region.
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