Kaur Harneet, Mohanty Sujata, Kochhar Gulsheen Kaur, Iqbal Shahid, Verma Anjali, Bhasin Ritasha, Kochhar Anuraj Singh
Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, Jamia Millia Islamia, Delhi 110025, Delhi, India.
Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Delhi 110002, Delhi, India.
World J Clin Cases. 2021 Dec 6;9(34):10671-10680. doi: 10.12998/wjcc.v9.i34.10671.
Fibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla.
A 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion.
The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.
骨纤维异常增殖症（FD）是一种发育性错构瘤性骨病，其特征是纤维和骨组织混合存在。尽管该肿瘤很少恶变，但大小和症状差异很大，可从小的无症状病变发展为相当大的病变，并逐渐进展，影响咬合和面部美观。治疗方法取决于骨骼成熟阶段。主要治疗手段是通过手术稳定病情发展。术后进行全面的牙科治疗对于恢复颌骨和牙齿的形态及功能很有必要。本文描述了1例FD上颌骨手术病例中严重错颌畸形的综合正畸治疗。
一名19岁女性因微笑时牙龈过度外露为主诉前来就诊。既往牙科病史包括右上颌前牙周围牙龈肿胀，15岁时被诊断为右上前颌骨段FD，并接受了发育异常骨的手术重塑治疗。临床和影像学检查显示术后愈合良好。手术治疗的发育异常区域表现为上颌前牙咬合平面右倾。上颌牙齿腭向扭转，右上颌尖牙牙根临床外露。我们讨论了通过综合固定正畸对相关错颌畸形的序贯治疗，以及为防止静止愈合病变复发而采取的特殊预防措施。
在发育异常骨中开始正畸牙齿移动之前，必须确保纤维发育异常骨术后充分愈合。需要定期随访以监测咬合稳定性和病变的任何复发情况。
