Fibrous dysplasia is a non-inheritable congenital disorder characterized by bone-forming expansile fibrous lesions that disrupt normal bone architecture. There are variety of treatment options-observation, bisphosphonate, Internal fixation only, Internal fixation with bone grafting.Replacement of normal bone by fibrous connective tissue and mineralized structures is a commonplace finding among fibro-osseous lesions (FOLs), including fibrous dysplasia, ossifying fibroma and cemento-osseous dysplasia. FOLs may occur as dysplastic, reactive or neoplastic conditions which require different treatments. Clinical, radiographic, and histopathologic findings are necessary for a definitive diagnosis and a successful management of affected individuals. Fibrous dysplasia is associated with postzygotic mutations of the GNAS gene, usually observed among individuals in the second and third decades of life. The evolution of this condition consists of an increase in volume that may stabilize with skeletal maturity. Typical radiographic features show a predominantly homogeneous radiopaque area with a poorly defined border and ground glass appearance frequently observed in the maxilla.

Due to swelling, surgery may be necessary for esthetic purposes. In contrast, ossifying fibroma is a neoplasm of persistent growth for which enucleation is highly recommended. Usually, this condition affects the mandible of individuals in the third and fourth decades of life. The radiographic image shows a typical mixed (radiolucent/radiopaque) mass with well-defined borders. More frequent than the first two lesions, cemento-osseous dysplasia mainly affects the jaw of middle-aged black women. The lesions involve tooth-bearing areas of radiolucent to radiopaque appearance, swelling has been rarely reported, and treatment or biopsies are not recommended. The radiographic features of FOLs may overlap and their diagnosis is challenging Due to the growth potential, clinical implications and treatment of these lesions, methods for the differentiation of FOLs have been proposed. Investigations of genetic mutations or histopathological findings such as the relationship between lesion and normal adjacent tissue , vascularity , and the presence of peri-trabecular clefting suggest differences between lesions.

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Mishita
Jornal co-ordinator
Journal of Bone Research and Reports