A. Involvement of several bones
B. Enlargement of the affected bones
Fibrous dysplasia is a developmental, benign fibro-osseous bone condition characterized by the replacement of normal cancellous bone with cellular fibrous connective tissue and poorly formed woven bone.
To answer this MCQ meticulously, let's evaluate each option based on the clinical, radiographic, and histological behavior of the lesion:
A. Involvement of several bones: True. Fibrous dysplasia can present in three primary clinical patterns: monostotic (involving a single bone), polyostotic (involving multiple bones), and McCune-Albright syndrome (polyostotic involvement with endocrinopathies and café-au-lait pigmentation).
B. Enlargement of the affected bones: True. As the proliferating fibro-osseous mass replaces normal bone architecture, it leads to a slow, painless, and progressive bony expansion, which often results in noticeable facial asymmetry when the maxilla or mandible is involved.
D. Displacement of teeth: True. The expansile nature of the lesion commonly causes bodily displacement or migration of adjacent teeth, disrupting the occlusal plane and leading to malocclusion. (Note: Root resorption is relatively rare, but displacement is a hallmark).
C. Associated with non-vital teeth: False. This is the exception. The teeth involved within or adjacent to a fibrous dysplasia lesion retain their normal neurovascular supply and remain vital. Loss of pulp vitality is typically associated with endodontic pathology, radicular cysts, or aggressive malignancies, rather than a developmental fibro-osseous defect. Pulp vitality testing in a purely fibrous dysplasia-affected segment will yield normal responses.
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