Oral and Maxillo-Facial Department, Provincial Rovigo Hospital, Italy.
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania- Italy.
Acta Biomed. 2020 Oct 13;92(1):e2021018. doi: 10.23750/abm.v92i1.9904.
Fibrous dysplasia is a fibro-osseous osteopathy in which the normal bone architecture is replaced by fibrous tissue and non-functional trabeculae-like osseous structures. In head and neck area monostotic or polyostotic lesions cause a progressively expanding destructive bone swelling producing cosmetic deformities and functional impairments. The aim of this article is to present a retrospective review of a clinical case series with pathologically confirmed jawbone fibrous dysplasia for over an 8-year-period.
Clinical presentation and radiographic features of fibrous dysplasia affecting the jawbone skeletal area, surgical procedures performed including the reconstructive methods employed and clinical outcomes were analysed for each patient.
Seven cases were classified as having monostotic fibrous dysplasia while the others four cases were classified as having polyostotic form. The mandible was most commonly involved. The most common presenting features included marked facial deformity, intraoral bulging, malocclusion and dental alterations. Aesthetic and/or functional impairments were the major indications for surgical treatment in all the patients of this series. Six patients underwent bone remodelling while in the remaining cases subtotal or total resection was performed. Bone reconstruction by means of autologous free bone grafts or revascularized free bone flaps was made in three cases.
The choice of the tailored therapeutic approach should be evaluated according the patient's age, rate of growth, anatomic location, type of involvement and the presence or not of functional disturbances and cosmetic alterations. Surgery remains the best therapeutic option.
纤维结构不良是一种纤维骨性骨病，其中正常骨结构被纤维组织和非功能性小梁样骨结构所取代。在头颈部，单发性或多发性病变导致进行性扩展的破坏性骨肿胀，导致美容畸形和功能障碍。本文的目的是回顾性分析一组经过 8 年以上病理证实的颌骨纤维结构不良的临床病例系列。
分析了影响颌骨骨骼区域的纤维结构不良的临床表现和影像学特征、手术程序，包括所采用的重建方法和临床结果。
7 例被分类为单发性纤维结构不良，而另外 4 例被分类为多发性纤维结构不良。下颌骨最常受累。最常见的表现包括明显的面部畸形、口腔内膨出、咬合不正和牙齿改变。在本系列的所有患者中，美容和/或功能障碍是手术治疗的主要指征。6 例患者接受了骨重塑，而在其余病例中进行了次全或全切除术。在 3 例病例中，通过自体游离骨移植或带血管游离骨瓣进行骨重建。
应根据患者的年龄、生长速度、解剖位置、受累类型以及是否存在功能障碍和美容改变来评估定制治疗方法的选择。手术仍然是最佳治疗选择。
