Mandibular fibrous dysplasia

Abstract

Fibrous dysplasia is a rare disease, a slowly progressive benign pseudotumoral osteopathy, characterized by a proliferation of connective fibrous tissue that replaces the medullary bone with trabeculated bone. It affects mainly the skull, the maxillofacial region and the long bones. It is a congenital and metabolic disorder. We present the case of a 20-year-old female patient from Tanzania, with a history of good health, who presented to the department of maxillofacial surgery of the Kitui Country Referral Hospital, Kenia, due to an abnormal and deforming growth in the lower third of the face, with more than six years of progress. She reported difficulty speaking, pain while eating hard food and having had repeated infectious processes. On intraoral examination a displacement of the left dental structures was found, as well as bleeding and reddened mucus with indentations resulted from the trauma caused by the upper teeth on the tumoral surface. She had a bad oral hygiene, halitosis and a curvature of the tongue and of the structures of the floor of the mouth towards the opposing side. CT scan showed an expansible image, with intralesional calcifications, that occupied the whole left mandibular region. A preoperative incisional biopsy was performed, which showed a mandibular fibrous dysplasia. Exeresis of the tumoral mass was performed with the placement of a titanium plate, restoring the lost mandibular bone and thus securing the space for future bone reconstructions. The early diagnosis of this condition would avoid aggressive procedures, making it possible to preserve the possible greatest amount of healthy bone.