Gigantocelularne lezije u čeljusti

master's thesis

• Title (english): Gigantocellular lesions in the jaw
• Author: Antonina Španje
• Mentor: Marko Granić (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024-07-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Gigantocelularne su lezije benigna, heterogena skupina stanja koje karakterizira prisutnost multinuklearnih divovskih stanica u fibroznoj stromi s najčešćom lokalizacijom u čeljusnim kostima. Prema klasifikaciji iz 2022., u ovu se skupinu ubrajaju centralne i periferne gigantocelularne lezije, kerubizam te jednostavna i aneurizmatska koštana cista. Svi oblici imaju vrlo sličnu kliničku sliku, mikroskopski i radiološki nalaz. Pojedini entiteti imaju svoje specifičnosti u vremenu manifestacije, lokalizaciji te u genetskim karakteristikama. Klinička slika varira između asimptomatskih lezija koje su slučajni radiološki nalaz i slučajeva s umjerenom boli, parestezijama i deformitetima. Smeđi tumor u hiperparatiroidizmu koštana je manifestacija metaboličke bolesti koja se dijagnosticira laboratorijskim testovima krvi i urina. Prema ostalim parametrima, smeđi je tumor istovjetan centralnoj gigantocelularnoj leziji, pri čemu je nužno laboratorijskim testovima isključiti metaboličke uzroke bolesti. U terapiji gigantocelularnih lezija primjenjuju se konzervativni i kirurški postupci. Konzervativna kirurška terapija uključuje enukleaciju, kiretažu sa ili bez osteotomije te parcijalnu resekciju, a odabir terapije ovisi o agresivnosti lezije. U posljednje se vrijeme nastoje popularizirati farmakološki tretmani, pri čemu se predlaže primjena kalcitonina, antiresorptivnih lijekova i imunomodulatora. Kako bismo što bolje razumjeli patogenezu, dijagnostiku i na kraju odabrali odgovarajuću terapiju ovih lezija, potrebna su daljnja istraživanja i rasprave.

Abstract (english)

Gigantocellular lesions are a benign, heterogeneous group of conditions which are characterised by the presence of multinuclear giant cells in fibrous stroma with the most common localisation in the jaw bones. According to the 2022 classification, this group includes central and peripheral gigantocellular lesions, cherubism and simple and aneurysmal
bone cysts. All forms have a very similar clinical picture, microscopic as well as radiological findings. Certain entities have their specific characteristics of the time of manifestation, localization and genetic characteristics. The clinical picture varies between asymptomatic lesions which are a random radiological finding and cases with moderate pain, paraesthesia and deformities. Brown tumour in hyperparathyroidism is a skeletal manifestation of metabolic disease diagnosed by laboratory blood and urine tests. According to other parameters, the brown tumour is identical to the central gigantocellular lesion therefore it is necessary to exclude the metabolic causes of the disease by laboratory tests. Pharmacological and non-pharmacological treatments are used in the treatment of giant cell lesions. Conservative surgical therapy includes enucleation, curettage with or without osteotomy and partial resection while the choice of therapy depends on the aggression of the lesion. In recent years there have been efforts to popularise pharmacological treatments suggesting the use of calcitonin, anti-resorptive agents and immunomodulators. In order to better understand pathogenesis, diagnostics and ultimately to select the appropriate therapy for these lesions further research and discussions are needed.

• Keywords: gigantocelularne lezije; centralna giganocelularna lezija; periferna gigantocelularna lezija; kerubizam; jednostavna koštana cista; aneurizmatska koštana cista; smeđi tumor; terapija lijekovima
• Keywords (english): Gigantocellular Lesions; Central Gigantocellular Lesion; Peripheral Gigantocellular Lesion; Cherubsm; Simple Bone Cyst; Aneurysmal Bone Cyst; Drug Therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:127:347850
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Repository: University of Zagreb School of Dental Medicine Repository
• Created on: 2024-07-03 12:09:34