# Fibrous dysplasia of the jaws: four cases with conservative and resective surgical management

## TL;DR

This paper presents four cases of fibrous dysplasia in the jaw, comparing conservative and resective surgical treatments with positive outcomes.

## Contribution

The study contributes four new clinical cases of fibrous dysplasia in the jaws and evaluates treatment approaches.

## Key findings

- Four patients with fibrous dysplasia in the maxillary or mandibular region underwent surgical treatment with no complications at six months.
- Conservative bone reshaping and resective surgery with reconstruction both yielded satisfactory clinical results.
- FD diagnosis relies on clinical, radiographic, and histopathological features due to its similarity to other fibro-osseous tumors.

## Abstract

Fibrous dysplasia (FD) is a slow-growing, benign fibro-osseous tumor with a recurrent character distinguished by replacement with fibrous connective tissue instead of normal bone. The medullary bone is substituted by fibrous connective tissue, leading to immature, poorly mineralized bone. FD is responsible for approximately 2.5% of all bone tumors and 7% of all benign bone tumours. Patients may show involvement of one bone (monostotic FD; MFD) or multiple bones (polyostotic FD; PFD). The present case report describes FD’s clinical, imaging and therapeutic aspects in the maxillary and mandibular region.

We present four cases of fibrous dysplasia affecting the maxilla and mandibular region, which were identified over 6 months at a single institution. All (n = 4) patients underwent surgical procedures: 2 patients in the mandibular region, one in the maxillary region, and one in the maxillary and mandibular region. No complications occurred at the six-month follow-up.

The diagnosis of FD is established based on clinical, radiographic, and histopathological features. Imaging analysis showed an expansive, non-destructive mass, with a well-circumscribed cortical and appearance of ground glass, involving either the maxilla or mandible. After diagnosis of FD, 3 patients undergo a conservative bone reshaping surgical procedure, and 1 patient undergoes a surgical resection and bone reshaping with primary wound closure.

The diagnosis of FD remains challenging because of its clinical, imaging, and histological similarities with other fibro-osseous tumors. A conservative approach of bone reshaping could be adopted as the first line of treatment for patients suffering from FD. A complete surgical removal by resective surgery and immediate reconstructive procedures also produces satisfactory clinical results after adequate follow-up.