calcitonin and Mandibular-Diseases

Recurrence is a major problem following the treatment of aggressive central giant cell granuloma (CGCG). The aim of this study was to compare the frequency of recurrence between patients who received calcitonin nasal spray after curettage of CGCGs and those who did not. A double-blind clinical trial was designed. Patients were allocated to one of two groups: those in the calcitonin group underwent curettage and received calcitonin salmon nasal spray 200IU/day once a day for 3 months after surgery; those in the control group underwent curettage of CGCGs and received a placebo once a day for 3 months after surgery. All patients were followed for 5 years after surgery. Twenty-four patients were treated in the two groups. There was no difference in age, sex, tumour size, or tumour location between the two groups (P>0.05). Eight of the 24 patients (33.3%) had recurrences during the follow-up period: one in the calcitonin group (9.1%) and seven in the control group (53.8%). Analysis of the data demonstrated a significant difference between the two study groups (P=0.033). It appears that calcitonin nasal spray may reduce the frequency of recurrence in aggressive CGCGs in the mandible and maxilla.

Topics: Adolescent; Adult; Bone Density Conservation Agents; Calcitonin; Double-Blind Method; Female; Granuloma, Giant Cell; Humans; Male; Mandibular Diseases; Maxillary Diseases; Nasal Sprays; Recurrence; Secondary Prevention

We present a case of chronic mandibular suppurative osteomyelitis after a routine extraction that required surgical and prolonged antimicrobial treatment. We also report the use of calcitonin as an adjunct to resolve symptoms of pain and possibly induce bony healing.

Topics: Anti-Bacterial Agents; Bone Density Conservation Agents; Calcitonin; Chronic Disease; Female; Humans; Mandibular Diseases; Mandibular Fractures; Middle Aged; Osteomyelitis; Tooth Extraction

Central giant cell granuloma (CGCG) is a benign lesion of the jaws with a sometimes locally aggressive behaviour. The most common therapy is surgical curettage which has a high recurrence rate, especially in lesions with aggressive signs and symptoms (i.e. pain, paresthesia, root-resorption and rapid growth). Alternative therapies such as interferon alpha (INFalpha) or calcitonin are described in the literature. In this study 2 patients with an aggressive CGCG are presented who were treated with INF mono-therapy. INF mono-therapy was capable of terminating the rapid growth of the lesion in both patients and induced a partial reduction. Total resolution, however, was not obtained and alternative treatment is still necessary.

Topics: Adolescent; Adult; Bone Density Conservation Agents; Calcitonin; Female; Granuloma, Giant Cell; Humans; Interferon-alpha; Male; Mandible; Mandibular Diseases; Maxilla; Maxillary Diseases; Radiography; Remission Induction; Treatment Failure