Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report
Identifieur interne : 002051 ( Pmc/Corpus ); précédent : 002050; suivant : 002052Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report
Auteurs : Alaa Z. Abu Gharbyah ; Mohammad AssafSource :
- International Journal of Surgery Case Reports [ 2210-2612 ] ; 2014.
Abstract
Peripheral Giant Cell Granuloma not responding to non-surgical treatment. Peripheral Giant Cell Granuloma surgical excision reversed the tooth migration caused by the lesion. Connective tissue grafting to prevent esthetic complications.
Url:
DOI: 10.1016/j.ijscr.2014.09.014
PubMed: 25290380
PubMed Central: 4245672
Links to Exploration step
PMC:4245672Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report</title><author><name sortKey="Abu Gharbyah, Alaa Z" sort="Abu Gharbyah, Alaa Z" uniqKey="Abu Gharbyah A" first="Alaa Z." last="Abu Gharbyah">Alaa Z. Abu Gharbyah</name><affiliation><nlm:aff id="aff0005">Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine</nlm:aff></affiliation></author><author><name sortKey="Assaf, Mohammad" sort="Assaf, Mohammad" uniqKey="Assaf M" first="Mohammad" last="Assaf">Mohammad Assaf</name><affiliation><nlm:aff id="aff0010">Department of Periodontology and Preventive Dentistry, Al-Quds University, Jerusalem, Palestine</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25290380</idno><idno type="pmc">4245672</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245672</idno><idno type="RBID">PMC:4245672</idno><idno type="doi">10.1016/j.ijscr.2014.09.014</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002051</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002051</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report</title><author><name sortKey="Abu Gharbyah, Alaa Z" sort="Abu Gharbyah, Alaa Z" uniqKey="Abu Gharbyah A" first="Alaa Z." last="Abu Gharbyah">Alaa Z. Abu Gharbyah</name><affiliation><nlm:aff id="aff0005">Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine</nlm:aff></affiliation></author><author><name sortKey="Assaf, Mohammad" sort="Assaf, Mohammad" uniqKey="Assaf M" first="Mohammad" last="Assaf">Mohammad Assaf</name><affiliation><nlm:aff id="aff0010">Department of Periodontology and Preventive Dentistry, Al-Quds University, Jerusalem, Palestine</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Surgery Case Reports</title><idno type="eISSN">2210-2612</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple"><list-item id="lsti0005"><label>•</label><p>Peripheral Giant Cell Granuloma not responding to non-surgical treatment.</p></list-item><list-item id="lsti0010"><label>•</label><p>Peripheral Giant Cell Granuloma surgical excision reversed the tooth migration caused by the lesion.</p></list-item><list-item id="lsti0015"><label>•</label><p>Connective tissue grafting to prevent esthetic complications.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Soames, J V" uniqKey="Soames J">J.V. Soames</name></author><author><name sortKey="Southam, J C" uniqKey="Southam J">J.C. Southam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Flaitz, C M" uniqKey="Flaitz C">C.M. Flaitz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pandolfi, P J" uniqKey="Pandolfi P">P.J. Pandolfi</name></author><author><name sortKey="Felefli, S" uniqKey="Felefli S">S. Felefli</name></author><author><name sortKey="Flaitz, C M" uniqKey="Flaitz C">C.M. Flaitz</name></author><author><name sortKey="Jhonson, J V" uniqKey="Jhonson J">J.V. Jhonson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Katsikeris, N" uniqKey="Katsikeris N">N. Katsikeris</name></author><author><name sortKey="Kakarantza Angelopoulou, E" uniqKey="Kakarantza Angelopoulou E">E. Kakarantza-Angelopoulou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Katsikeris, N" uniqKey="Katsikeris N">N. Katsikeris</name></author><author><name sortKey="Kakarantza Angelopoulou, E" uniqKey="Kakarantza Angelopoulou E">E. Kakarantza-Angelopoulou</name></author><author><name sortKey="Angelopoulos, A P" uniqKey="Angelopoulos A">A.P. Angelopoulos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kfir, Y" uniqKey="Kfir Y">Y. Kfir</name></author><author><name sortKey="Buchner, A" uniqKey="Buchner A">A. Buchner</name></author><author><name sortKey="Hansen, L" uniqKey="Hansen L">L. Hansen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bodner, L" uniqKey="Bodner L">L. Bodner</name></author><author><name sortKey="Peist, M" uniqKey="Peist M">M. Peist</name></author><author><name sortKey="Gatot, A" uniqKey="Gatot A">A. Gatot</name></author><author><name sortKey="Fliss, D M" uniqKey="Fliss D">D.M. Fliss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eversole, L F" uniqKey="Eversole L">L.F. Eversole</name></author><author><name sortKey="Rovin, S" uniqKey="Rovin S">S. Rovin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mighell, A J" uniqKey="Mighell A">A.J. Mighell</name></author><author><name sortKey="Robinson, P A" uniqKey="Robinson P">P.A. Robinson</name></author><author><name sortKey="Hume, W J" uniqKey="Hume W">W.J. Hume</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="other"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Surg Case Rep</journal-id><journal-id journal-id-type="iso-abbrev">Int J Surg Case Rep</journal-id><journal-title-group><journal-title>International Journal of Surgery Case Reports</journal-title></journal-title-group><issn pub-type="epub">2210-2612</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25290380</article-id><article-id pub-id-type="pmc">4245672</article-id><article-id pub-id-type="publisher-id">S2210-2612(14)00223-5</article-id><article-id pub-id-type="doi">10.1016/j.ijscr.2014.09.014</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Abu Gharbyah</surname><given-names>Alaa’ Z.</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Assaf</surname><given-names>Mohammad</given-names></name><email>massaf@dentist.alquds.edu</email><email>mmassaf@gmail.com</email><xref rid="aff0010" ref-type="aff">b</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine</aff><aff id="aff0010"><label>b</label>Department of Periodontology and Preventive Dentistry, Al-Quds University, Jerusalem, Palestine</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine. Tel/fax: +970 22791065. <email>massaf@dentist.alquds.edu</email><email>mmassaf@gmail.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>22</day><month>9</month><year>2014</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>22</day><month>9</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>5</volume><issue>11</issue><fpage>779</fpage><lpage>782</lpage><history><date date-type="received"><day>28</day><month>6</month><year>2014</year></date><date date-type="accepted"><day>9</day><month>9</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 The Authors</copyright-statement><copyright-year>2014</copyright-year><license license-type="CC BY-NC-ND" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><license-p>This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).</license-p></license></permissions><abstract abstract-type="author-highlights"><title>Highlights</title><p><list list-type="simple"><list-item id="lsti0005"><label>•</label><p>Peripheral Giant Cell Granuloma not responding to non-surgical treatment.</p></list-item><list-item id="lsti0010"><label>•</label><p>Peripheral Giant Cell Granuloma surgical excision reversed the tooth migration caused by the lesion.</p></list-item><list-item id="lsti0015"><label>•</label><p>Connective tissue grafting to prevent esthetic complications.</p></list-item></list></p></abstract><abstract><sec><title>INTRODUCTION</title><p>Peripheral Giant Cell Granuloma (PGCG) is the most common giant cell lesion found in the jaws; it originates from the connective tissue of the periosteum or from the periodontal ligament in response to local chronic irritation. Early and accurate diagnosis of these lesions allows for conservative management without compromising adjacent teeth or tissues.</p></sec><sec><title>PRESENTATION OF CASE</title><p>This paper presents a case of PGCG in the esthetic zone of the upper jaw in a 23-year-old female patient. The treatment offered consisted of an excisional biopsy with immediate soft tissue grafting to prevent esthetic complications. The growing lesion has caused an interproximal spacing between the central and lateral incisors. The spacing spontaneously closed during the next six weeks after excision and no relapse occurred during postoperative follow-up.</p></sec><sec><title>DISCUSSION</title><p>Proper management of a PGCG lesion requires excluding other pathologies prior to planning for surgery. Correct diagnosis of such lesions is essential to optimize the treatment and prevent recurrence. Clinical examination alone may not give a correct picture, thereby requiring histopathological confirmation.</p></sec><sec><title>CONCLUSION</title><p>Immediate soft tissue augmentation using a connective tissue graft has been suggested as a surgical solution after removal of PGCG to minimize patient discomfort and the loss of precious tissues.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>Peripheral Giant Cell Granuloma</kwd><kwd>Excisional biopsy</kwd><kwd>Connective tissue graft</kwd><kwd>Oral lesion</kwd><kwd>Gingival enlargement</kwd></kwd-group></article-meta></front><body><sec sec-type="intro" id="sec0005"><label>1</label><title>Introduction</title><p>Peripheral Giant Cell Granuloma (PGCG) is a localized tumor-like gingival enlargement and it is a hyperplastic not a neoplastic lesion.<xref rid="bib0005" ref-type="bibr"><sup>1</sup></xref> It is an occasional lesion of the oral cavity, originating from the interdental tissues (periosteum or periodontal membrane) following local irritation or chronic trauma particularly from subgingival plaque and calculus.<xref rid="bib0010 bib0015 bib0020" ref-type="bibr"><sup>2–4</sup></xref> Tough these lesions occur over a wide age range; the peak incidence in males is in the second decade compared to the fifth decade for females.<xref rid="bib0005" ref-type="bibr"><sup>1</sup></xref> Moreover, PGCG lesions are up to twice as frequent in the mandible as in the maxilla.<xref rid="bib0025" ref-type="bibr"><sup>5</sup></xref></p><p>Lesions can arise anywhere on the gingival or alveolar mucosa in dentate or edentate patients, but most occur anterior to the molar teeth. However, in dentate areas lesions usually arise in the interdental papilla. Also, it can be found in the edentulous alveolar margin or at marginal gingival level.<xref rid="bib0010 bib0030 bib0035" ref-type="bibr"><sup>2,6,7</sup></xref></p></sec><sec sec-type="case-study" id="sec0010"><label>2</label><title>Case report</title><p>A 23 years old female patient was referred by her dentist to Alpha Clinic – a private clinic limited to periodontics and dental implants that is located in Ramallah, Palestine – for an exophytic gingival growth on the anterior buccal maxillary gingiva (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>).</p><p>On the first visit in May 2012, the patient reported that a small mass has been progressively growing since February 2012. The growth was painless but bleeding was detected on provocation. The patient was breast feeding and her infant was 10 months old at the date of intake. She stated that she has not received any medication during the last year. She reported that hormonal disturbances have been recognized after delivery and that levels have subsided significantly during the last few months. No significant findings were detected in the extra-oral examination.</p><p>In the intra-oral examination, a solitary pedunculated, exfoliated, lesion was observed in the gingiva between upper left central and lateral incisor. The lesion was reddish and 8 mm × 12 mm in maximum dimensions. On palpation, the lesion had a firm consistency. The contour was regular with determined margins and was associated with a flaring space between the two incisors of 2 mm at the contact area level (<xref rid="fig0010" ref-type="fig">Fig. 2</xref>). The spacing has only been recently observed by the patient together with the growing lesion. There was no occlusal trauma with opposing teeth to explain the pathological migration of any of these incisors. The patient's oral hygiene status was poor. No history of acute or chronic physical trauma to the affected area was reported by the patient.</p><p>Intra-oral peri-apical radiograph revealed no pathological findings with slight localized reduction of the level of interdental bone between the two upper left incisors. The lamina dura was detected adjacent to the periodontal ligament spaces, but the crestal bone showed less opacity (<xref rid="fig0015" ref-type="fig">Fig. 3</xref>). Related teeth (#21 and #22) responded positively to cold test ruling out the possibility of endodontic origin of disease. Complete Blood Count was performed and all blood results were within normal limits (RBCs: 4.66 × 10<sup>12</sup>/L, Hg: 12.5 g/dl, and WBC: 8.48 × 10<sup>9</sup>/L).</p><p>The patient received comprehensive examination that was followed by two scaling sessions and provided with proper oral hygiene instructions.</p><p>After 3 months, the lesion was re-evaluated and no significant changes were recorded in its clinical appearance. Thus, the patient was scheduled for surgical excision. Under local anesthesia, the lesion was excised down to the periosteum; a thin layer of alveolar bone was resected as well (<xref rid="fig0020" ref-type="fig">Fig. 4</xref>). A connective tissue graft was placed on the defect area to compensate the excised tissues and to avoid an esthetic complication in the anterior region (<xref rid="fig0025" ref-type="fig">Fig. 5</xref>). The excised tissue was sent for histo-pathological analysis in CAP LABS (Center for Advanced Pathology Labs, Bethlehem, Palestine) (<xref rid="fig0030" ref-type="fig">Fig. 6</xref>).</p><p>The histo-pathological analysis showed mucosa with well circumscribed lesion that consists of numerous osteoclast-like giant cells near hemorrhagic areas. The presence of cellular, vascular and fibrous stroma with scattered mitotic figures was reported; and no necrosis was observed (<xref rid="fig0035" ref-type="fig">Fig. 7</xref>).</p><p>During the first six weeks after excision, spontaneous closure of the space with the relapse of the incisors to their normal position in the upper arch occurred. Follow up visits were scheduled at three week intervals. Scaling and oral hygiene instructions were performed on every recall visit. No signs of recurrence of the lesion have been observed during first year after the excision. There was no esthetic problem caused by the excision; this is due to proper healing of the connective tissue graft on the healthy tooth surface (<xref rid="fig0040" ref-type="fig">Fig. 8</xref>). A written consent was taken from the patient for publishing her case in the scientific literature.</p></sec><sec sec-type="discussion" id="sec0015"><label>3</label><title>Discussion</title><p>Clinically, PGCG has characteristics which separate it from the fibrous and vascular epulides. It presents as a firm, soft, bright pedunculated or sessile nodule with various sizes: that range from small papules to enlarged masses; though they are generally less than 20 mm in diameter. The color can range from dark red to purple or blue commonly with ulcerated surface.<xref rid="bib0010 bib0015 bib0020 bib0035" ref-type="bibr"><sup>2–4,7</sup></xref> Pain is not a common characteristic, and lesion growth in most cases is induced by repeated trauma.<xref rid="bib0005" ref-type="bibr"><sup>1</sup></xref></p><p>PGCG is a soft tissue lesion that rarely affects the underlying bone, though the latter may suffer superficial erosion.<xref rid="bib0010 bib0015" ref-type="bibr"><sup>2,3</sup></xref> Radiographs may reveal superficial erosion of the crest of the interdental bone or, in edentulous areas, of the alveolar bone margin but these are not constant feature.<xref rid="bib0005" ref-type="bibr"><sup>1</sup></xref></p><p>The differential diagnosis of PGCG includes lesions with very similar clinical and histological characteristics, such as central giant cell granuloma, which are located within the jaw itself and exhibit a more aggressive behavior. Only radiological evaluation can establish the distinction between central and peripheral forms of giant cell granulomas.</p><p>The treatment of PGCG comprises surgical resection with elimination of the entire base of the lesion in addition to the eradication of the underlying source of irritant factors.<xref rid="bib0010 bib0020" ref-type="bibr"><sup>2,4</sup></xref> If incomplete bone resection was done, the growth may recur.<xref rid="bib0010" ref-type="bibr"><sup>2</sup></xref> To avoid recurrence after treatment, in addition to complete simple excision with extensive clearing of the base of the lesion, the source of irritation needs to be eradicated.<xref rid="bib0030" ref-type="bibr"><sup>6</sup></xref></p><p>Recurrence of PGCG is infrequent, ranges as little as 5–11% have been reported.<xref rid="bib0040 bib0045" ref-type="bibr"><sup>8,9</sup></xref> Early diagnosis based on clinical and radiological findings and confirmed by pathological analysis allows for conservative management with less risk of destruction for the adjacent teeth and tissues.</p><p>This case shows that the proper management of a PGCG lesion requires excluding other pathologies prior to diagnosis, which is confirmed by the histopathological analysis of the excised lesion. Surgical excision with bone resection removed the lesion with no signs of recurrence. Soft tissue grafting using a connective tissue graft to prevent esthetic complications was performed immediately after surgical excision.</p></sec><sec id="sec0050"><title>Conflict of interest</title><p>No conflicts to declare.</p></sec><sec id="sec0055"><title>Funding</title><p>None.</p></sec><sec id="sec0060"><title>Ethical approval</title><p>Written informed consent was obtained from the patient for publication of this case report and accompanying images.</p></sec><sec id="sec0065"><title>Author contributions</title><p>Dr. Alaa’ Z. Abu Gharbyeh: Data collection, writing the paper, follow-up of patient.</p><p>Dr. Mohammad Assaf: surgical procedure.</p></sec></body><back><ref-list><title>References</title><ref id="bib0005"><label>1</label><element-citation publication-type="book" id="sbref0005"><person-group person-group-type="author"><name><surname>Soames</surname><given-names>J.V.</given-names></name><name><surname>Southam</surname><given-names>J.C.</given-names></name></person-group><chapter-title>Oral pathology</chapter-title><edition>4th ed.</edition><year>2000</year><publisher-name>Oxford</publisher-name></element-citation></ref><ref id="bib0010"><label>2</label><element-citation publication-type="journal" id="sbref0010"><person-group person-group-type="author"><name><surname>Flaitz</surname><given-names>C.M.</given-names></name></person-group><article-title>Peripheral giant cell granuloma: a potentially aggressive lesion in children</article-title><source>Pediatr Dent</source><volume>22</volume><year>2000</year><fpage>232</fpage><lpage>233</lpage><pub-id pub-id-type="pmid">10846736</pub-id></element-citation></ref><ref id="bib0015"><label>3</label><element-citation publication-type="journal" id="sbref0015"><person-group person-group-type="author"><name><surname>Pandolfi</surname><given-names>P.J.</given-names></name><name><surname>Felefli</surname><given-names>S.</given-names></name><name><surname>Flaitz</surname><given-names>C.M.</given-names></name><name><surname>Jhonson</surname><given-names>J.V.</given-names></name></person-group><article-title>An aggressive peripheral giant cell granuloma in a child</article-title><source>J Clin Pediatr Dent</source><volume>23</volume><year>1999</year><fpage>353</fpage><lpage>355</lpage><pub-id pub-id-type="pmid">10551138</pub-id></element-citation></ref><ref id="bib0020"><label>4</label><element-citation publication-type="journal" id="sbref0020"><person-group person-group-type="author"><name><surname>Katsikeris</surname><given-names>N.</given-names></name><name><surname>Kakarantza-Angelopoulou</surname><given-names>E.</given-names></name></person-group><article-title>Peripheral giant cell granuloma: clinico-pathologic study of 224 new cases and 956 reported cases</article-title><source>Int J Oral Maxillofac Surg</source><volume>17</volume><year>1988</year><fpage>94</fpage><lpage>99</lpage><pub-id pub-id-type="pmid">3133432</pub-id></element-citation></ref><ref id="bib0025"><label>5</label><element-citation publication-type="journal" id="sbref0025"><person-group person-group-type="author"><name><surname>Katsikeris</surname><given-names>N.</given-names></name><name><surname>Kakarantza-Angelopoulou</surname><given-names>E.</given-names></name><name><surname>Angelopoulos</surname><given-names>A.P.</given-names></name></person-group><article-title>Peripheral giant cell granuloma: clinicopathologic study of 224 new cases and review of 956 reported cases</article-title><source>Int J Oral Maxillofac Surg</source><volume>17</volume><year>1988</year><fpage>94</fpage><lpage>99</lpage><pub-id pub-id-type="pmid">3133432</pub-id></element-citation></ref><ref id="bib0030"><label>6</label><element-citation publication-type="journal" id="sbref0030"><person-group person-group-type="author"><name><surname>Kfir</surname><given-names>Y.</given-names></name><name><surname>Buchner</surname><given-names>A.</given-names></name><name><surname>Hansen</surname><given-names>L.</given-names></name></person-group><article-title>Reactive lesions of the gingiva: a clinicopathological study of 741 cases</article-title><source>J Periodontol</source><volume>51</volume><year>1980</year><fpage>655</fpage><lpage>661</lpage><pub-id pub-id-type="pmid">6936553</pub-id></element-citation></ref><ref id="bib0035"><label>7</label><element-citation publication-type="journal" id="sbref0035"><person-group person-group-type="author"><name><surname>Bodner</surname><given-names>L.</given-names></name><name><surname>Peist</surname><given-names>M.</given-names></name><name><surname>Gatot</surname><given-names>A.</given-names></name><name><surname>Fliss</surname><given-names>D.M.</given-names></name></person-group><article-title>Growth potential of peripheral giant cell granuloma</article-title><source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source><volume>83</volume><year>1997</year><fpage>548</fpage><lpage>551</lpage><pub-id pub-id-type="pmid">9159813</pub-id></element-citation></ref><ref id="bib0040"><label>8</label><element-citation publication-type="journal" id="sbref0040"><person-group person-group-type="author"><name><surname>Eversole</surname><given-names>L.F.</given-names></name><name><surname>Rovin</surname><given-names>S.</given-names></name></person-group><article-title>Reactive lesions of the gingiva</article-title><source>J Oral Pathol</source><volume>1</volume><year>1972</year><fpage>30</fpage><lpage>38</lpage><pub-id pub-id-type="pmid">4626993</pub-id></element-citation></ref><ref id="bib0045"><label>9</label><element-citation publication-type="journal" id="sbref0045"><person-group person-group-type="author"><name><surname>Mighell</surname><given-names>A.J.</given-names></name><name><surname>Robinson</surname><given-names>P.A.</given-names></name><name><surname>Hume</surname><given-names>W.J.</given-names></name></person-group><article-title>Peripheral giant cell granuloma: a clinical study of 77 cases from 62 patients and literature review</article-title><source>Oral Dis</source><volume>1</volume><year>1995</year><fpage>12</fpage><lpage>19</lpage><pub-id pub-id-type="pmid">7553374</pub-id></element-citation></ref></ref-list><ack id="ack0005"><title>Acknowledgement</title><p>The authors would like to thank Dr. Areej Al-Khateeb (Head of Center of Advanced Pathology Labs, Bethlehem, Palestine) for her contribution in the histo-pathological analysis.</p></ack></back><floats-group><fig id="fig0005"><label>Fig. 1</label><caption><p>Exophytic gingival growth on the anterior buccal maxillary gingiva.</p></caption><graphic xlink:href="gr1"></graphic></fig><fig id="fig0010"><label>Fig. 2</label><caption><p>Solitary, pedunculated, exfoliated, lesion in the gingiva between upper left central and lateral incisors.</p></caption><graphic xlink:href="gr2"></graphic></fig><fig id="fig0015"><label>Fig. 3</label><caption><p>Intra-oral peri-apical radiograph revealing slight localized reduction of the level of interdental crestal bone between the two incisors.</p></caption><graphic xlink:href="gr3"></graphic></fig><fig id="fig0020"><label>Fig. 4</label><caption><p>Excision of lesion.</p></caption><graphic xlink:href="gr4"></graphic></fig><fig id="fig0025"><label>Fig. 5</label><caption><p>Connective tissue graft sutured on defect area to compensate the excised tissues and to avoid an esthetic complication.</p></caption><graphic xlink:href="gr5"></graphic></fig><fig id="fig0030"><label>Fig. 6</label><caption><p>The excised tissue was sent for histo-pathological analysis after being placed in a container with formalin.</p></caption><graphic xlink:href="gr6"></graphic></fig><fig id="fig0035"><label>Fig. 7</label><caption><p>Histo-pathological analysis showing numerous osteoclast-like giant cells near hemorrhagic areas, no necrosis observed.</p></caption><graphic xlink:href="gr7"></graphic></fig><fig id="fig0040"><label>Fig. 8</label><caption><p>One year follow-up, no signs of recurrence of the lesion have been observed.</p></caption><graphic xlink:href="gr8"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002051 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 002051 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV2
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:4245672
|texte= Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:25290380" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |