Clinical study of benign and malignant fibrous-osseous lesions of the jaws
이주민, 송원욱, Lee Jae-Yeoul, 황대석, 김용덕, 신상훈, Chung In-Kyo, 김욱규,
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이주민 ( Lee Ju-Min ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
송원욱 ( Song Won-Wook ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
( Lee Jae-Yeoul ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
황대석 ( Hwang Dae-Seok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김용덕 ( Kim Yong-Deok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
신상훈 ( Shin Sang-Hun ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
( Chung In-Kyo ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김욱규 ( Kim Uk-Kyu ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 0355620120380010029
Abstract
Introduction: Fibrous-osseous lesions of the jaws are difficult to diagnose precisely until excised biopsy results are found, so they might be confused with malignant lesions. This clinical study focused on the diagnostic aids of lesions that demonstrate different clinical, radiologic, and histological findings. Materials and Methods: A total of 16 patients with benign fibrous-osseous lesions on the jaws (6 fibrous dysplasias, 6 ossifying fibromas, 3 cemental dysplasias, and one osteoblastoma) were reviewed. Nine patients with malignant fibrous-osseous lesions (8 osteosarcomas and one Ewing’s
sarcoma) were also retrospectively reviewed. Results: Osteosarcoma patients complained of facial swelling and tooth mobility. The radiographic findings showed the irregular resorption of cortical bone and periosteal reactions. Histological features included cellular pleomorphism and atypical mitosis. An Ewing’s sarcoma patient complained of tooth mobility and facial swelling. Onion-skin appearance and irregular expansile marginal bony radiolucency were seen in the radiography. Fibrous dysplasia patients complained of facial swelling and asymmetry. The radiographic features were mostly ground-glass radiopacity. Histological findings showed a bony trabeculae pattern surrounded by fibrous ground substances. Ossifying fibroma patients complained of buccal swelling and jaw pains, showing expanded cortical radiolucent lesions with a radiopaque margin. Histological findings were revealed as cellular fibrous stroma with immature
woven bones. In cemental dysplasia, most of their lesions were found in a routine dental exam. Well circumscribed radiopaque lesions were observed in the radiography, and cementum-like ossicles with fibrous stroma were seen in the microscopy. An osteoblastoma patient complained of jaw pain and facial swelling. Radiographic findings were mottled, dense radiopacity with osteolytic margin. Trabeculae of the osteoid with a vascular network and numerous osteoblasts with woven bone were predominantly found in the microscopy. Conclusion: Our study showed similar results as other studies. We suggest the clinical parameters of diagnosis and treatment for malignant and benign fibrous-osseous lesions of the jaws.
키워드
Fibrous-osseous lesions of the jaws; Fibrous dysplasia; Ossifying Fibroma; Ewing’s sarcoma; Osteoblastoma
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