Management of Progressive Mandibular Fibrous Dysplasia With Radical Resection and Immediate Reconstruction Using Autoclaved Autograft: A Case Report

采用根治性切除和即刻自体骨移植(经高压灭菌处理)重建治疗进行性下颌骨纤维性发育不良:病例报告

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Abstract

Fibrous dysplasia is an uncommon condition in which fibrous elements and immature bones progressively replace normal skeletal tissue. When the mandible is involved, patients may develop swelling, asymmetry, and functional difficulties, which require careful differentiation from other jaw pathologies to avoid misdiagnosis. This report describes the case of a 48-year-old man who presented with a slowly enlarging, painless swelling of the lower jaw accompanied by mobile teeth and impaired chewing ability. Clinical and radiographic investigations revealed a diffuse lesion with a characteristic ground-glass radiographic appearance, and histopathological analysis confirmed the diagnosis of fibrous dysplasia. Routine blood test results were within normal limits. Surgical management was performed using an extraoral approach. The affected bone was recontoured after osteotomy, sterilized by autoclaving, and repositioned with the aid of a reconstruction plate to maintain the mandibular form and stability. Postoperatively, healing was initially favorable; however, delayed intraoral wound breakdown with bone exposure occurred six months after the procedure. This complication was successfully corrected using a secondary procedure involving plate removal and careful closure. At one year, the patient exhibited satisfactory bone stability, improved masticatory efficiency, and acceptable esthetics without evidence of lesion progression. This case highlights the importance of accurate diagnosis, personalized surgical planning, and ongoing patient follow-up for those with mandibular fibrous dysplasia.

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