Surgical treatment of fibrous dysplasia of the cranio-maxillo-facial area. Review of the literature and personal experience form 1984 to 1999.

OBJECTIVE

The aim of this study is to report personal experience on the evolution of the therapeutical approach and surgical treatment in 66 patients with fibrous dysplasia (FD) of the cranio-maxillo-facial area.

METHODS

From January 1984 to December 1999, 66 cases of FD of the cranio-maxillo-facial area were diagnosed. 21 patients were still growing (under 17 years), while 45 were adults (over 17 years). 50 (75.7%) patients showed FD in monostotic form; 15 (22.7%) patients showed FD in polyostotic form; one (1.51%) patient affected by Mc Cune-Albright Syndrome presented the involvement of the left hemimandible. In 24 (36.3%) patients the clinical onset of the disease was insidious, lacked evident symptomatology and the diagnosis was fortuitous. The remaining 42 (63.6%) patients showed different signs and symptoms according to the location of the pathology.

RESULTS

In this time the patients who underwent surgical treatment showed the resolution of the functional and aesthetical problems; the patients who did not undergo surgical treatment, in relation to age and type of pathology, showed an arrest during clinical and radiographic checks.

CONCLUSIONS

We have pointed out the importance of a careful differential diagnosis of fibrous dysplasia with other pathologies with clinical and radiographic conditions similar to it and the importance of a correct surgical planning, carried out according to the patient's age, location, mono or polyostotic form of fibrous dysplasia and to the presence or absence of functional limitations, and aesthetic problems. Further-more we have pointed out the great possibilities of reconstruction of the surgical defects deriving from the utilization of autologous bone grafts and the benefits deriving from the introduction of the internal rigid fixation for the stabilization of these grafts in the surgical defects.