A central giant cell granuloma is a type of bone lesion that appears along the jaw. It is a noncancerous condition that is usually painless, but irritation and open lesions in the mouth can lead to an infection and uncomfortable swelling. Doctors do not fully understand what causes these lesions to appear, but trauma to the jaw from direct injuries and surgical procedures often precede lesions. Granulomas that become problematic are usually treated with a combination of medications and surgery.
In most cases, a central giant cell granuloma arises along the lower jaw. The condition is most commonly seen in female patients under the age of 30, but doctors do not know why young women are more susceptible than other patients. A lesion begins deep within the mandible in bone marrow tissue and can erupt through the bone and surrounding cartilage and skin within about one month. A black or dark-purple sore can be seen along the very bottom of the lower gums as a central giant cell granuloma develops and ruptures blood vessels. A similar, much more common lesion called a peripheral giant cell granuloma can develop closer to the teeth on the lower gums or elsewhere in the mouth.
Aside from the physical appearance of the mouth lesion, a central giant cell granuloma is unlikely to cause adverse symptoms. Some patients report tenderness in the jaw and fatigue after eating or speaking. If a mouth sore opens, it becomes susceptible to infections that can cause pain, swelling, and tenderness in the mouth.
A dentist can usually diagnose a central giant cell granuloma by evaluating the physical appearance of the ulcer. He or she usually asks about any recent trauma to the jaw, previous dental work, and the patient's current dental hygiene regimen to rule out other possible causes. X-rays are taken to check for signs of jaw damage, and a small tissue sample may be collected from the lesion to make sure it is not a cancerous tumor.
The primary treatment for a central giant cell granuloma is surgery. A maxillofacial surgeon can use a specialized type of scalpel to cut out the visible mouth lesion and damaged interior jaw tissue. Corticosteroids and other anti-inflammatory medications are either injected or given orally to help relieve swelling and pain while the mouth heals. Antibiotics may also be given in the case of infection. With surgical care, most patients experience full recoveries and to not have recurring jaw or mouth problems.