Maxillofacial fibrous dysplasia: a diagnostic challenge

Abstract

A 30-year-old woman presented for orthodontic treatment, with a chief symptom of a 'shifting bite' and concurrent facial asymmetry with aesthetic concerns. The patient had previously received treatment from several general dentists and several specialists, without accurate diagnosis. Radiological investigation coupled with biopsy confirmed a diagnosis of fibrous dysplasia. Proper diagnosis led to changes in the treatment plan and gave the patient realistic expectations about the options she had for the outcome of treatment. Prompt diagnosis by dental practitioners is critical to patient satisfaction and successful outcome; therefore, it is important to familiarise ourselves with the signs, symptoms and proper course of management of fibrous dysplasia.

Figure 1

Frontal profile demonstrating right asymmetry of the face.

Figure 2

Profile from below showing asymmetry of the right maxillary region.

Figure 3

Frontal profile on smiling displaying excessive gingiva with maxillary cant.

Figure 4

Intraoral image showing asymmetry of the right maxilla, open bite on left side.

Figure 5

Panoramic radiograph showing radiopaque lesion across the right maxillary region.

Figure 6

Multiplanar reconstruction view exhibiting expansion of the right maxilla; thin buccal cortical plate and volume rendering displaying posterior open bite.