Eversole R, Su L, ElMofty S. Benign fibro-osseous lesions of the craniofacial complex. A review. Head Neck Pathol. 2008; 2:177-202
Oluwaseun AA, Salcedo SE, Borad V, Richard SS, Workman AD, Ray AO. Fibrous dysplasia: an overview of disease process, indications for surgical management, and a case report. Eplasty. 2015; 15
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Fibrous dysplasia is a bone disorder whereby normal medullary bone is replaced by fibrous tissue. Many sites may be affected, including the craniofacial skeleton. A 33-year-old female presented at the Bristol Dental Hospital in 2007 complaining of a prominent and expanding lower jaw as well as poor aesthetics. She was diagnosed with craniofacial polyostotic fibrous dysplasia. In order to manage her concerns and the ongoing growth of the polyostotic lesions, a combined maxillofacial and restorative approach was utilized. After ten years of ongoing management and care, including surgery and dental rehabilitation, her primary concerns have been addressed.
CPD/Clinical Relevance: The clinician should be able to understand the clinical and radiographic appearance of craniofacial fibrous dysplasia, how the condition can impact a patient and the complex management that may be involved.
Article
There have been many classifications of bone-related conditions and fibro-osseous lesions. The most recent classification includes the one by Eversole et al,1 which is as follows:
Fibrous dysplasia (FD) is a rare congenital sporadic disease of bone, which can affect the jaws, as well as other bones in the skeleton. First reported by Von Recklinghausen in 1891,2 it is known to develop in childhood, manifesting before the age of 10. Histologically, it is characterized by the resorption of normal bone, and subsequent replacement by a benign connective tissue matrix, haphazardly arranged, and poorly calcified woven bone. These lesions may become more radio-opaque with age due to the increase in bone density associated with bone expansion.1
There are two subtypes of fibrous dysplasia in the literature:
Fibrous dysplasia can present in any bone in the body; the most common sites include the ribs, femur and craniofacial skeleton. A higher prevalence is noted in the maxilla, rather than the mandible, with maxillary lesions extending to include the maxillary sinus, zygoma, sphenoid bone and floor of the orbit.3 Fibrous dysplasia can cause bony pain, dental anomalies, pathological fractures, as well as facial deformities, and therefore management can be challenging.4
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