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Fibro-ossifying Lesions (Cemento-Osseous Dysplasia (Types: (Periapical
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Fibro-ossifying Lesions
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Fibrous Dysplasia
A developmental tumor-like condition caused by a mutation to the GNAS1 gene
= presentation depends on WHEN mutation occurred in development
Presentations
MFD - Monostotic
- More Common (6X more common than PFD)
- Craniofacial FD even though effecting more than one bone is still considered MFD (usually single bone)
- M=F + No racial predilection
PFD - Polystotic
- Multiple bones affected
- Females (3:1)
- Assoc. conditions:
- Jaffe-Lichtenstein syndrome: polyostotic + café au lait pigmentation
- McCune-Albright syndrome: polyostotic + pigmentation + endocrinopathy + precocious puberty
Features
Clinical
- Expansion of jaw
- Slow growth
- Limited growth potential (bone dev. stops = so does condition
- Painless swelling +/- facial asymmetry
- May cause dental problems:
- Displacement of teeth, occlusion problems
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Histological
- FCT with high cellularity
- Only woven bone (irregular)
- lesional bone fuses to normal bone and becomes more opaque w/ normal bone maturity
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Solitary Bone Cyst
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Clinically
- Well defined uni (mostly) or multi (if large) radiolucency
- extends between roots w/ no resorption/displacement
- <10% show expansion
Histologically
- intraossoeous cavity devoid of an epithelial lining