Maxillofacial Plastic and Reconstructive Surgery

  • Volume 40
  • /
  • Pages.37.1-37.7
  • /
  • 2018
  • /
  • 2288-8101(pISSN)
  • /
  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지
DOI QR코드

DOI QR Code

Orthognathic surgery for patients with fibrous dysplasia involved with dentition

  • Udayakumar, Santhiya Iswarya Vinothini (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Paeng, Jun-Young (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, So-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Shin, Hong-In (Department of Oral Pathology, School of Dentistry, Institute for Hard Tissue and Bio-tooth Regeneration, Kyungpook National University) ;
  • Lee, Sung-Tak (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Kwon, Tae-Geon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University)
  • Received : 2018.10.09
  • Accepted : 2018.10.19
  • Published : 2018.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.

Keywords

References

  1. Ricalde P, Magliocca KR, Lee JS (2012) Craniofacial fibrous dysplasia. Oral Maxillofac Surg Clin North Am 24:427-441 https://doi.org/10.1016/j.coms.2012.05.004
  2. Burke AB, Collins MT, Boyce AM (2017) Fibrous dysplasia of bone: craniofacial and dental implications. Oral Dis 23:697-708 https://doi.org/10.1111/odi.12563
  3. Ricalde P, Horswell BB (2001) Craniofacial fibrous dysplasia of the frontoorbital region: a case series and literature review. J Oral Maxillofac Surg 59:157-167 discussion 167-8 https://doi.org/10.1053/joms.2001.20487
  4. Fattah A, Khechoyan D, Phillips JH, Forrest CR (2013) Paediatric craniofacial fibrous dysplasia: the Hospital for Sick Children experience and treatment philosophy. J Plast Reconstr Aesthet Surg 66:1346-1355 https://doi.org/10.1016/j.bjps.2013.05.031
  5. Sachs SA, Kleiman M, Pasternak R (1984) Surgical management of a facial deformity secondary to craniofacial fibrous dysplasia. J Oral Maxillofac Surg 42:192-196 https://doi.org/10.1016/S0278-2391(84)80033-6
  6. Samman N, Piette E, Cheung LK, Tideman H (1991) Feasibility of osteotomies in fibrous dysplasia of the jaws. Int J Oral Maxillofac Surg 20:353-356 https://doi.org/10.1016/S0901-5027(05)80264-4
  7. Cheung LK, Samman N, Pang M, Tideman H (1995) Titanium miniplate fixation for osteotomies in facial fibrous dysplasia--a histologic study of the screw/bone interface. Int J Oral Maxillofac Surg 24:401-405 https://doi.org/10.1016/S0901-5027(05)80467-9
  8. Yeow VK, Chen YR (1999) Orthognathic surgery in craniomaxillofacial fibrous dysplasia. J Craniofac Surg 10:155-159 https://doi.org/10.1097/00001665-199903000-00012
  9. Matsuo A, Kono M, Toyoda J, Nakai T, Tsuzuki M, Chiba H (2010) Navigation surgery for Le fort 1 osteotomy in a fibrous dysplasia patient. Odontology 98:181-184 https://doi.org/10.1007/s10266-010-0124-5
  10. Magraw CB, Golden BA, Turvey TA (2013) Stability of rigid fixation in craniofacial fibrous dysplasia and cherubism: report of two cases and review of the Literature. J Oral Maxillofac Surg Poster 48:e68-e69 1 Sept 2013 https://doi.org/10.1016/j.joms.2013.06.124
  11. Triaca A, Minoretti R, Saulacic N (2010) Mandibula wing osteotomy for correction of the mandibular plane: a case report. Br J Oral Maxillofac Surg 48:182-184 https://doi.org/10.1016/j.bjoms.2009.08.011
  12. Stanton RP, Ippolito E, Springfield D, Lindaman L, Wientroub S, Leet A (2012) The surgical management of fibrous dysplasia of bone. Orphanet J Rare Dis 7(Suppl 1):S1 https://doi.org/10.1186/1750-1172-7-S1-S1
  13. Kruse A, Pieles U, Riener MO, Zunker C, Bredell MG, Gratz KW (2009) Craniomaxillofacial fibrous dysplasia: a 10-year database 1996-2006. Br J Oral Maxillofac Surg 47:302-305 https://doi.org/10.1016/j.bjoms.2009.01.008
  14. Wu H, Li J, Xu J, You C, Huang S (2014) Recurring craniofacial fibrous dysplasia with extensive titanium mesh invasion. J Craniofac Surg 25:697-699 https://doi.org/10.1097/SCS.0000000000000612
  15. Boyce AM, Burke A, Cutler Peck C, DuFresne CR, Lee JS, Collins MT (2016) Surgical management of polyostotic craniofacial fibrous dysplasia: long-term outcomes and predictors for postoperative regrowth. Plast Reconstr Surg 137:1833-1839 https://doi.org/10.1097/PRS.0000000000002151
  16. Hussein MA, Yun IS, Kim BO, Kim YO (2017) Craniofacial fibrous dysplasia: retrospective study on the relationship between the tumor volume changes and the circulating serum calcitonin and serum alkaline phosphatase. Ann Plast Surg 78:289-293 https://doi.org/10.1097/SAP.0000000000000917
  17. Ma J, Liang L, Gu B, Zhang H, Wen W, Liu H (2013) A retrospective study on craniofacial fibrous dysplasia: preoperative serum alkaline phosphatase as a prognostic marker? J Craniomaxillofac Surg 41:644-647 https://doi.org/10.1016/j.jcms.2012.12.007
  18. Park BY, Cheon YW, Kim YO, Pae NS, Lee WJ (2010) Prognosis for craniofacial fibrous dysplasia after incomplete resection: age and serum alkaline phosphatase. Int J Oral Maxillofac Surg 39:221-226 https://doi.org/10.1016/j.ijom.2009.12.008

Cited by

  1. An unusual presentation of non-specific cystic degeneration of craniofacial fibrous dysplasia: a case report and review of literature vol.42, pp.None, 2018, https://doi.org/10.1186/s40902-020-00275-2
  2. Extensive titanium mesh invasive cranial fibrous dysplasia vol.12, pp.None, 2018, https://doi.org/10.25259/sni_63_2021