International Journal of Medical and Pharmaceutical

Case Reports
7(1): XX-XX, 2016; Article no.IJMPCR.24060
ISSN: 2394-109X, NLM ID: 101648033

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Bilateral Fibrous Dysplasia of the Upper and Lower

Jaws: Case Report
Haifa Hussain Alharbi1*
1

Ministry of Health, Riyadh, KSA.

Authors contribution

The sole author designed, analyzed and interpreted and prepared the manuscript.
Article Information
DOI: 10.9734/IJMPCR/2016/24060
Editor(s):
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(2)
(3)
(4)
Reviewers:
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(6)
Complete Peer review History:

Case Study

Received 1st January 2016

th
Accepted 27 February 2016
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Published 8 March 2016

ABSTRACT
Aim: To present a case with bilateral fibrous dysplasia of the upper and lower jaws.
Presentation of Case: A patient had mild pain in the lower jaw without any specific localization.
From the patients diagnosis, it was revealed that he had a past medical history that included skin
disorder rosacea and medium intellectual disability, imaging showed confirmed the presence of a
lesion in the jaws bone. The lesion was found to have no soft-tissue a condition that differentiates
fibrous dysplasia (FD) from a malignancy.
Discussion: FD of the cranium is idiopathic rare disorder in which normal bone is replaced by
abnormal fibro-connective tissue proliferation. In 36, 3% of the cases of FD the clinical beginning is
hidden, there is no clear symptoms and obtaining the diagnosis is complicated. The rest of the
patients (63, 6%) are with diverse symptoms depending on location, swelling, deformation and
presence of pain.
Conclusion: It can be difficult to differentiate between FD from other benign and malignant bone
disorders because of the isolated cases of FD in the maxillo-mandibular region.
_____________________________________________________________________________________________________
*Corresponding author: E-mail: rn.adham@gmail.com;

Alharbi; IJMPCR, 7(1): xxx-xxx, 2016; Article no.IJMPCR.24060

Keywords: Bilateral; fibrous dysplasia; upper and lower jaws; intellectual disability.
The color of the surrounding and covering
mucosa of the oral cavity was normal and did not
show any signs of inflammation or ulceration.
The examining physician expected fibrous
dysplasia as initial diagnosis depending on the
symptoms and signs on the upper and lower jaw.
Radiological imaging done, but it was difficult to
determine the nature of that lesion is it benign or
malignant. Fig. 1 showed confirmed the presence
of a lesion in the jaws bone. Biopsy was taken
from the lesion. The lesion was benign and this
agrees with other studies relevant to fibrous
dysplasia of jaws [7-11].

1. INTRODUCTION
Fibrous dysplasia (FD) affecting the jaws is an
uncommon developmental anomaly. It may be
divided into three categories; The first type
involves a single bone commonly referred to as
monostatic (74%), The second type includes
multiple lesions comprising several bones
referred to as ploystatic (13%). When seen with
caf au lait (coffee with milk) pigmentation,
Polyostotic fibrous dysplasia also may be
combined with caf au lai pigmentation and
multiple endocrinopathies is known as the
McCune-Albright syndrome. and The third is
craniofacial (13%) which commonly found in the
McCune-Albright syndrome, which includes
endocrine abnormalities [1,2]. The last category,
identifed by Davis and Yardley, [3] appears to be
confned to the face and jaws involving two or
more bones. The specifc cause of fibrous
dysplasia is unknown, but a common theory for
the monostotic form is that a nonspecifc reaction
to some disturbance induces an excessive
proliferation of connective tissue [4]. According to
SARGIN [5], in 1937among all the disorders
associated with bone formation, fibrous dysplasia
is very extreme and should be classified on its
own.

Fig. 1. Presence of a lesion in the jaws bone

3. DISCUSSION
Fibrous dysplasia of the cranium is characterized
by the replacement of the normal bone by
abnormal fibro-connective tissue. According to
clinical records cases of FD at least in 36, 3%.
The other (63, 6%) of the cases from different
patients exhibit diverse symptoms. The different
symptoms vary from one patient to another due
to the difference in location. Some of the
symptoms include swelling, deformation and
presence of pain [12].

There is also another definition of the term

fibrous dysplasia stating that the disorder is an
arrest of bone maturation. The defect from
maturation is a woven bone ossification that is as
a result of metaplasia of nonspecificfibroosseous type [6]. The aim of this case report is to
present a case with bilateral fibrous dysplasia of
the upper and lower jaws.

2. CASE REPORT
The amount of alkaline phosphate should
regularly be monitored to avoid its increase that
results in malignant transformation. The cause of
pain in the lower jaw of the patient is due from
the compression of the mandible nerve as a
result of the enlargement of the fibrous tissue.

Before about 6 years, we received as twentyeight male case in Oral surgery department of
the Medical University. The case had mild pain in
the lower jaw without any specific localization.
From the diagnosis, it was revealed that he had a
past medical history that included skin disorder
rosacea and moderate intellectual disability with
emotional-volitional instability and prolonged
neurotic decomposition. There was no family
history of similar medical disorders.

Treatment of the disorder is the most appropriate

way to correct the functionality problem in
combination with aesthetic effects. Surgical
treatment method results in long-term postoperative complications [13].

In clinical examination, there was presence of

symmetrical bilateral expansion in the distal part
of the alveolar ridge of lower and upper jaws, and
skeletal survey done and it was free.

4. CONCLUSION
It can be difficult to differentiate between fibrous
dysplasia from other benign and malignant bone
2

Alharbi; IJMPCR, 7(1): xxx-xxx, 2016; Article no.IJMPCR.24060

disorders because of the isolated cases of

fibrous dysplasia in the maxillo-mandibular
region. In cases of maxillo-mandibular the dentist
identifies the condition before administering any
treatment. Therefore, adequate knowledge of the
state is necessary for proper diagnosis,
treatment,
and
prevention
of
further
complications.

5.

Sargin H, Gozu H, Bircan R, Sargin M,

Avsar M, Ekinci G, Yayla A, Gulec I,
Bozbuga M, Cirakoglu B, Tanakol R. A
case of McCune-Albright syndrome
associated with Gs alpha mutation in the
bone tissue. Endocrine Journal. 2006;
53(1):35-44.
6.
Rajarathnam BN, David MP, Naveen N.
Fibrous dysplasia-review of literature.
ETHICAL CONSIDERATION
7.
Cooke
BED.
Benign
fibro-osseous
enlargements of the jaws. Br Dent J. 1957;
102(1).
The author got approvals from the biomedical
Goaz
PW.
White,
sC:
Oral
board of the Medical University and informed 8.
radiology. Principles and lnterpretation.
consent from the case.
2nd ed. 5The CV, MOSby Co. 1987;587608.
COMPETING INTERESTS
9.
Slootweg PJ, Mller H. Differential
diagnosis of fibro-osseous jaw lesions: A
Author has declared that no competing interests
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2016 Alharbi; This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.

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