Dentist № 1 (48) – 2023, pp. 8-19                                                                                                              SCIENTIFIC PUBLICATION

Surgical treatment of fibrous dysplasia of the maxilla

F.A. Gorbachev

MD, PhD, Associate Professor, Belarusian State Medical University, Minsk, Belarus

https://doi.org/10.32993/dentist.2023.1(48).9

ABSTRACT
Fibrous dysplasia is a congenital benign neoplasm of bones. The treatment of the facial skeleton bones fibrous dysplasia may be conservative with the use of bisphosphonate therapy and surgical.
The aim of the study was to study the results of surgical treatment of patients with fibrous dysplasia of the maxilla.
Objects and methods. The object of the research were 5 patients who were treated at the maxillofacial surgery department of 11th Minsk Municipal Clinical Hospital in the period from 2016 to 2021. Prior to radical surgical treatment, all patients underwent cone-beam computed tomography, scintigraphy, trepan biopsy, computer designed 3D models of the bones of the middle zone of the face for modeling individual titanium mesh implants, patients underwent removal of a tumor-like formation by resection within healthy tissues with simultaneous iliac autologous bone grafting using individually made titanium mesh implants and standard miniplates. Before radical surgical treatment all patients underwent cone beam computed tomography, scintigraphy, trephine biopsy, creation of 3D midfacial bones models for modeling individual titanium mesh implants. Patients underwent tumor-like formation removal by resection within healthy tissues with simultaneous autologous iliac crest bone grafting with use of individually made titanium mesh implants and standard miniplates.
Results and discussion. Treatment results were estimated on the basis of clinical examination and the analysis of cone beam computed tomography data during the first 7 days, in 4-6 months, in 12-18 months after the surgery. 3 patients were rehabilitated using restoration on dental implants installed in the area of reconstructed alveolar ridge according to a two-stage technique. Rehabilitation of 3 patients were carried out with use of fixed orthopedic constructions on dental implants placed in the area of reconstructed alveolar ridge according to a two-stage protocol. The surgical method of treatment of fibrous dysplasia is the most optimal in case of a significant deformation of the midfacial bones and pain syndrome.
Conclusion. Modern surgical treatment protocol allows not only radical removal of the tumor-like formation, but also allows complete recovery of masticatory functions with a positive aesthetic result. Preoperative planning with use of 3D modeling allows to increase precision of the resection area and reconstruction of the missing bone structures, also it reduces surgery time and decreases complications risk.

Keywords: fibrous dysplasia, maxilla resection, bone grafting, dental implants

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Correspondence to:  Е-mail: gorb-75@tut.by