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Management of Massive Mandibular Fibrous Dysplasia with Radical Excision and Different Immediate Reconstructive Modalities: Case Series Report

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Abstract

Purpose

To review and represent three different mandibular reconstruction modalities following surgical treatment of massive mandibular fibrous Dysplasia (MMFD).

Methods

The present retrospective case series study was conducted on 24 patients who had MMFD and treated via resection and immediate reconstruction at Al-Azhar University Hospitals, Egypt. Patients were divided into three groups according to the grafting procedure. Group I patients were grafted with iliac bone graft (IBG), group II patients were grafted with IBG and bone marrow aspirate concentrate (BMAC), while group III patients were grafted with free vascularized fibula graft (FVFG). Postoperative clinical and radiographic assessments were performed immediately, at 6 months, 12 months and 2 years to evaluate lesion recurrence and bone graft resorption. Other study variables included assessment of postoperative wound dehiscence, infection rate, amount of edema, and facial bone contour.

Results

The parameters of the clinical analysis showed non-statistically significant differences among all groups. Postoperative wound healing was clinically uneventful in all groups, except for two cases of wound dehiscence in group I (8.3%) and one case in group III (4.2%). Most patients had appropriate postoperative facial contour, and adequate facial symmetry. The radiographic measurements revealed a highly statistically significant difference between group I and II at 12 months, and two years, without any statistically significant difference between group II and III.

Conclusion

MMFD surgical defect should be repaired for function and cosmetics aims especially in young adult patients. The findings of the present study have shown that when compared to traditional IBG alone or FVFG, the use of autogenous IBG with BMAC injection produces a favorable outcome with few difficulties.

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Acknowledgment

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Funding

No funding received.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University for Boys (Assuit), Assuit, 11727, Egypt

    Abdel Aziz Baiomy Abdullah Baiomy

  2. Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, 11884, Egypt

    Shadia Abdelhameed Elsayed & Fatma Ahmed Khalifa

  3. Department of Oral and Maxillofacial Surgery, Taibah University Dental College and Hospital, Al-Madinah Al-Munawwrah, 344/42353, Saudi Arabia

    Shadia Abdelhameed Elsayed

  4. Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Ahram Canadian University, 6th of October City, Egypt

    Mohamed Ashraf Abdelfattah

Authors
  1. Abdel Aziz Baiomy Abdullah Baiomy
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  2. Shadia Abdelhameed Elsayed
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  3. Mohamed Ashraf Abdelfattah
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  4. Fatma Ahmed Khalifa
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Correspondence to Shadia Abdelhameed Elsayed.

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All procedures performed in the study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the present study

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Baiomy, A.A.B.A., Elsayed, S.A., Abdelfattah, M.A. et al. Management of Massive Mandibular Fibrous Dysplasia with Radical Excision and Different Immediate Reconstructive Modalities: Case Series Report. J. Maxillofac. Oral Surg. 21, 1311–1319 (2022). https://doi.org/10.1007/s12663-021-01660-8

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  • DOI: https://doi.org/10.1007/s12663-021-01660-8

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