Microvascularized Fibular Bone Grafting for the Treatment of Mandibular Expansive Osseous Dysplasia - A Case Report

Abstract

Abstract Rationale: Osseous dysplasia (OD) is a benign fibro-osseous lesion classified as periapical, focal or florid with some rare cases being diagnosed as expansive OD. Patient Concerns: A 43-year-old female presented with gross mandible expansion and tooth displacement. Diagnosis: Imaging scans revealed an expansive lesion in the anterior mandible, with varying opacity in the central region, and other smaller lesions in the region of teeth #37 and #47, consistent with expansive OD. Treatment: Surgical resection followed by immediate reconstruction of the mandibular defect using a microvascularized fibular graft. Outcomes: The patient had a 4-year follow-up, with adequate mandibular bone continuity, mastication, swallowing, and speaking ability reestablished. Take-away Lessons: Immediate reconstruction after large surgical resection is required as tissues retract over time, hampering late reconstructions. Microvascularized fibular graft aims at adequate and functional rehabilitation with osseointegrated implants and long-term follow-up is needed as florid OD may evolve into expansive OD.