Pharmacologic management of central giant cell granuloma of the jaws: a systematic review of effectiveness and safety.

OBJECTIVE: To evaluate the effectiveness, safety, and outcomes of pharmacologic therapies for CGCG of the jaws and their role relative to surgery. STUDY DESIGN: This PRISMA-guided systematic review searched seven electronic databases for original human studies published between 1988 and 2025. Eligible studies included histologically confirmed CGCG treated with pharmacologic agents alone or with surgery. Data on treatment modalities, clinical and radiographic outcomes, recurrence, and adverse effects were extracted and qualitatively synthesized. RESULTS: Seventy-six articles were included. Intralesional corticosteroids and denosumab showed the most consistent regression and radiographic ossification. Corticosteroids had a favorable safety profile, particularly in non-aggressive lesions, whereas denosumab produced rapid symptomatic improvement but carried risks of rebound hypercalcemia and recurrence after cessation. Calcitonin showed slower, less predictable responses, whereas interferon-α and bisphosphonates were mainly adjunctive or rescue therapies. Combined medical-surgical strategies generally reduced surgical morbidity and facilitated more conservative treatment. CONCLUSIONS: Pharmacologic therapy is an effective, less invasive option for selected CGCG cases. A practical evidence-informed treatment algorithm is proposed to guide selection of observation, conservative surgery, intralesional corticosteroids, denosumab, or adjunctive/rescue agents according to lesion aggressiveness, patient age, recurrence status, and anticipated surgical morbidity. Careful patient selection and long-term follow-up remain essential.