الفهرس 
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Abstract
Background: Central giant cell granuloma (CGCG) is a benign but locally aggressive intraosseous lesion of jaws presenting in children and young adults. These lesions are reported more frequently in females and most often occur in the mandible. The clinical feature of CGCG ranges from a slow growing asymptomatic swelling to a rapidly enlarging painful aggressive lesion. It divided into non-aggressive and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. Multiple treatment modalities had been used with different degree of success, surgical treatment has been the traditional treatment modality ranging from local curettage, peripheral ostectomy to en bloc resection for aggressive lesions which results in the loss of teeth and tooth germs, especially in younger patients. Medical therapy is indicated when surgery is associated with increased morbidity or to decrease recurrence, Calcitonin and Corticosteroids as a therapy for CGCG of the jaws is a promising alternative treatment as calcitonin has a direct inhibiting effect on osteoclasts and Steroids has apoptotic action on osteoclast-like cells. Purpose: The aim of this study was clinical and radiographic evaluation of the effect of calcitonin subcutaneous injection with and without intra-lesional corticosteroid injection for management of aggressive central giant cell granuloma of the jaws. Patients and methods: This study was carried out on sixteen patients complaining from aggressive CGCG of the jaws. The patients were selected from the outpatient clinic, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Tanta University. The patients were divided into two equal groups. group I received Salmon calcitonin as subcutaneous injection for 6 months while group II received salmon calcitonin as subcutaneous injection for 6 months with intra-lesional corticosteroid injection 6 injections weekly intervals. The patients were followed up clinically for facial asymmetry, pain, mobility of related teeth and radiographically using panoramic x-ray 3 months post injection and Computed Tomography CT scan 6 months post injection for extension and size of the lesion. Results: Reduction in lesions size in 75% of our patient in both groups with increased calcification, thickening of the cortical plates and radiological bone remodeling has been seen after 6 months post injection. Case no. 5 & 8 group I and case no.7 group II showing minimal response to treatment without increase in size while case no.1 group II showed continuous growth Conclusion: This study suggested that, no benefit of starting treatment of aggressive CGCG with a combination therapy of calcitonin and intralesional corticosteroid injection, as there was no significant difference regarding lesions size reduction between the two groups after 6 month post injection, so calcitonin alone may be effective without exposing patients to another medical treatment with its limitations and side effects. Only suggest a combination therapy if calcitonin alone has failed.