下顎骨單骨性纖維性發育不良－病例報告

纖維性發育不良（fibrous dysplasia）是一種類腫瘤病變，特徵為正常的骨骼組織，被大量再生不良且帶有異常骨小樑的纖維結締組織所取代。大部分的臨床案例皆為無症狀的單骨性（monostotic）病變，病患通常是接受其他牙科治療時，才發現病灶存在。本文敘述一位接受牙周病治療的四十三歲女性，於放射線檢查時意外發現右下大臼齒區根尖處有一放射線透過性合併放射線不透過性病變，懷疑為纖維骨性類病變（fibro-osseous lesions），然而臨床上並無明顯不適症狀，因此僅針對牙周病部分進行治療與定期門診追蹤。四年後，病患因咬合不適回診檢查，發現該區牙周復發且原本放射線透過性病變有擴大情形，於是轉介口腔外科門診評估與進一步治療。數週後，病患住院接受手術切除病變與組織切片檢查，最終診斷為下顎骨單骨性纖維性發育不良。本文將針對此疾病之致病機轉、分類與症狀、相關檢查以及治療與預後，回顧相關文獻並作一整體性討論。

關鍵字

纖維性發育不良；下顎骨；牙周病

並列摘要

Fibrous dysplasia is a tumorlike lesion which is characterized by replacement of normal bone by an excessive proliferation of dysplastic fibrous connective tissue containing abnormal trabecular bone. Most clinical examples are asymptomatic monostatic lesions and discovered incidentally in other dental treatments. We presented a 43-year-old female, who was accidently found a mixed radiolucent-radiopaque lesion at right lower molar apical region by periapical radiography during periodontal treatment, which fibro-osseous lesion was suspected. Initially, there was no obvious clinical symptom, so we only focused on the periodontal treatment and recalled the patient for regular follow up. Four years later, the patient came back to our clinic due to biting discomfort. We found recurrent periodontal disease accompanied with expanded radiolucent lesion at the original area, so we referred the patient to oral and maxillofacial surgery department for further assessment and treatment. After surgical removal of the lesion and histopathologic examinations, the final diagnosis was mandibular monostotic fibrous dysplasia. In this article, we discussed the etiology, classification with symptoms, clinical examinations and prognosis related to the disease with literature review.

並列關鍵字

fibrous dysplasia ； mandible ； periodontal disease

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下顎骨單骨性纖維性發育不良－病例報告

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