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年轻患者张口受限的纤维骨性病变的外科治疗

Surgical Treatment of Fibroosseous Lesion in Young Patient with Reduced Mouth Opening.

作者信息

de Azambuja Carvalho Pedro Henrique, Torriani Marcos Antonio, Post Letícia Kirst, Chagas Otacílio Luiz

机构信息

Department of Diagnosis and Oral and Maxillofacial Surgery, Faculdade de Odontologia Campus de Araraquara, Universidade Estadual Paulista Julio de Mesquita Filho, Araraquara, Brazil.

Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil.

出版信息

Craniomaxillofac Trauma Reconstr. 2018 Dec;11(4):314-319. doi: 10.1055/s-0037-1608697. Epub 2017 Nov 16.

Abstract

Fibrous dysplasia is a benign fibroosseous disorder that can affect the maxillary bones, causing aesthetic deformity and functional impairment. This article reports the case of a 13-year-old male patient at the time of diagnosis. The patient showed increased facial volume with relevant asymmetry, having reported the onset of the condition 12 months before. Upon examination, the patient presented an 8-mm mouth opening and an acute inflammatory process associated with tooth 37 pericoronal hood. Upon imaging exam, exuberant bone growth in the left mandibular ramus area of ground glass aspect was observed. After incisional biopsy, fibrous dysplasia was diagnosed and sequentially treated with osteoplasty and coronoid process removal. The patient evolved to a 43-mm mouth opening and favorable aesthetics without recurrence in a 3-year follow-up period. In this case, coronoidectomy and bone plasty proved to be effective, returning aesthetics and function. The patient is supposed to be followed up in the long term.

摘要

骨纤维异常增殖症是一种良性骨纤维性疾病,可累及上颌骨,导致美观畸形和功能障碍。本文报告了一名13岁男性患者的诊断情况。患者面部容积增大且伴有明显不对称,自述该病症已发作12个月。检查时,患者开口度为8毫米,伴有与37号牙冠周龈瓣相关的急性炎症过程。影像学检查发现,左侧下颌升支区域有磨玻璃样的骨质过度生长。切开活检后,诊断为骨纤维异常增殖症,并依次进行了骨成形术和冠突切除术。在3年的随访期内,患者开口度增至43毫米,美观效果良好且无复发。在该病例中,冠突切除术和骨成形术被证明是有效的,恢复了美观和功能。患者应进行长期随访。

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