Peri-implant peripheral giant cell lesions: report of 13 new cases and comparative histological and immunohistochemical analysis with peripheral and central giant cell lesions

Abstract

Background Few cases or peri-implant peripheral giant cell lesions (PGCL) have been reported in the literature. The aim of this study was to report 13 new cases of peri-implant PGCL and compare the expression of smooth muscle actin, Bcl-2 protein, GLUT-1, CD68, osteoprotegerin, receptor activator of nuclear factor kappa-B, Ki-67 and CD34 in these cases with PGCL and central giant cell lesions (CGCL). Material and Methods Clinical data were retrieved from the laboratory records and histological analysis was performed using HE-stained slides. Immunohistochemical reactions for the above mentioned antibodies were performed and digitally scored. Results Peri-implant PGCL mostly affected the posterior mandible of adult females. CD68 and Bcl-2 expressions were higher in conventional PGCL and CGCL than in peri-implant PGCL (p=0.033 for CD68 and p<.0001 for Bcl-2). Microvessel density was higher in conventional peripheral than in central and peri-implant PGCL (p=0.002). Proliferative index of the mononuclear cells showed no statistically significant differences comparing the three groups but it was higher in peri-implant PGCL. Conclusions The current study demonstrated that peri-implant PGCL is more common in the posterior mandible of adult females. There were some differences in microvessel density, proliferative activity and expression of CD68 and Bcl-2 among conventional PGCL, peri-implant and CGCL. Further studies are encouraged to better understand these early findings. Key words:Giant cell lesion, giant cell granuloma, peripheral, dental implants, immunohistochemistry.

An analysis of the prevalence of peripheral giant cell granuloma and pyogenic granuloma in relation to a dental implant

“…This could possibly be influenced by the fact that some professionals surgically remove the peri-implant tissues and do not send them for a histopathological study [ 13 ], or simply do not publish the cases. An interesting study, without conclusive results, found some differences in microvascular density, proliferative activity, and CD68 and Bcl-2 expression, between conventional and implant-associated granulomatous lesions [ 40 ]. In this study, histological and immunohistochemical aspects of peri-implant granulomatous lesions were analyzed and 13 new cases were presented, 2 in men and 11 in women.…”

Peripheral Giant Cell Granuloma of the Jaws as First Sign of Primary Hyperparathyroidism: A Case Series

“…This wide range and high recurrence rate could be related both to incomplete removal of the lesions along with teeth or implants severely involved in the lesions and probably to the lack of screening of hormonal imbalances after certain histological diagnosis of PGCG is achieved. Histologically, PGCG not associated with PHPT are characterized by an increase of microvessel density and Bcl-2 and CD68 expressions [ 24 ] and mutations of KRAS and MAPK [ 25 ]. Nevertheless, further studies are necessary in order to understand if these findings are detectable in PGCG associated to PHPT too.…”

OralImmunoAnalyser: a software tool for immunohistochemical assessment of oral leukoplakia using image segmentation and classification models

“…The development of computerized methods to analyze biopsies in order to make diagnostic and prognostic assessments, mainly based on cell morphology and architecture, is an open challenge (Irshad et al, 2014 ). The Aperio system 1 (Morais et al, 2019 ) is a commercial solution, which has been used in the immunohistochemical study of oral lesions, and offers solutions for slide glass scanning and automatic analysis of immunohistochemical staining. ImageJ (Rueden et al, 2017 ) is a freely accessible software that has also been used in the immunohistochemical study of oral lesions (Park et al, 2020 ).…”