Abstract
Fibrous dysplasia is a benign skeletal disorder in which the normal bone and marrow are replaced by fibrous tissue and haphazardly distributed woven bone. The aim of this case report is to discuss the orthodontic treatment of a 13-year-old patient with fibrous dysplasia in the left maxilla. The patient had rotated maxillary second premolars, moderate crowding in both maxillary and mandibular arches with low maxillary frenal attachment. Orthodontic treatment was done with full fixed appliance and extraction of maxillary and mandibular third molars. Maxillary frenectomy and free gingival graft in mandibular anterior region were performed by a periodontist. The oral and maxillofacial surgery team monitored fibrous dysplasia in the left maxilla on a yearly interval. There is very limited information about orthodontic management of patients with craniofacial fibrous dysplasia. This case report discusses the orthodontic treatment and the importance of interdisciplinary approach in the management of patient with maxillofacial fibrous dysplasia. Key words:Orthodontic treatment, fibrous dysplasia, maxillofacial fibrous dysplasia, case report.
Highlights
Fibrous dysplasia (FD), first described by Lichtenstein in 1938, is a benign skeletal disorder in which the normal bone and marrow are replaced by fibrous tissue and haphazardly distributed woven bone [1]
Due to severe malocclusion and high caries index, more frequent dental recall is recommended to e300
Our patient was diagnosed with FD as evidenced by panoramic radiographs and CT scans in the left maxillary sinus area, which was significantly filled with FD bone tissue and radiopacity (Fig. 1d)
Summary
Fibrous dysplasia (FD), first described by Lichtenstein in 1938, is a benign skeletal disorder in which the normal bone and marrow are replaced by fibrous tissue and haphazardly distributed woven bone [1]. In its quiescent or non-aggressive forms, FD is often discovered during routine dental examination or orthodontic evaluation This case report discusses the orthodontic diagnosis and treatment of a patient with maxillofacial FD. The scan showed an approximately 4 cm x 3 cm lesion in the left maxillary sinus with ground glass appearance in addition to mild bony expansion of the left maxilla (Fig. 2a). -Treatment Objectives The treatment objectives were to 1) resolve 1.4mm and 5.2mm crowding in the maxillary and mandibular arch and maintain transverse dimensions, 2) derotate maxillary second premolars, 3) correct posterior buccal crossbite of maxillary right second premolar, 4) maintain Class I molar on right, achieve Class I molar on left and Class I canine on both sides, 5) achieve optimum overbite and overjet, and 6) level the curve of spee and achieve ideal lip balance relative to E-plane.
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