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Maxillofacial fibrous dysplasia: A clinical analysis of 72 cases

Objective: To analyse the clinical characteristics and imaging findings of maxillofacial fibrous dysplasia and the relationship between serum alkaline phosphatase and its clinical relative factors.

Method: The clinical materials of 72 fibrous dysplasia patients were reviewed and the alkaline phosphatase among monostotic fibrous dysplasia, polyostotic fibrous dysplasia and non-fibrous dysplasia group (control group) were statistically analysed by variance (ANOVA) using the SPSS 22.0 software.

Result and Discussion: There were 53 monostotic fibrous dysplasia (73.6%) and 19 polyostotic fibrous dysplasia (26.4%) among the 72 cases. Most fibrous dysplasia cases were not obvious boundary but ground glass type. The X-image classification of fibrous dysplasia showed that there were 44 cases of ground glass (61.1%), 10 cases of nodular sclerosis type (13.9%), 3 cases of cystic type (4.2%) and 15 cases of mixed type (20.8%). Before operation, serum alkaline phosphatase in polyostotic fibrous dysplasia group was (216.1 ± 248.7) U/L, significantly higher than (66.2 ± 14.9) U/L in control group and (118.8 ± 92.2) U/L in monostotic fibrous dysplasia group. After treatment, the serum alkaline phosphatase was (66.2 ± 14.9) U/L in control group, significantly higher than (118.8 ± 92.2) U/L in the 53 monostotic cases and (216.1 ± 248.7) U/L in the 19 polyostotic cases, P<0.01. There was no significantly statistical difference between control group and monostotic group. There were 17 relapses. 14 cases were relapses when they were admitted to hospital. According to the observation of recurrence cases, all the monostotic fibrous dysplasia’s primary site was mandible. Authors suggested that it may relate to the operative way, anatomy and morphology of the upper and lower jaw. All the follow-up recurrence cases occurred in the mandible and first symptom was like inflammation, which might be associated with the anatomical characteristics of the mandible, surgical resection extent, proper treatment, and the short follow-up time.

Conclusion: Fibrous dysplasia is a fibrous bone lesion while the maxillofacial region is one of the predilection sites. No significant gender differences in the disease. The increase of serum alkaline phosphatase may be associated with the range of fibrous dysplasia lesions. The operation type can be chosen according to the patients’ condition, and the appropriate time for surgery is post-adolescence.

Author(s): Yadan Fan, Jiannan Liu, Chenping Zhang, Zhiyuan Zhang, Huawei Yang, Jingzhou Hu