Male patient, 22 years old, comes to the maxillofacial surgery service of San José Hospital derived by its painless volume increase in relation to the left mandibular branch and odontological evolution body.
The patient had no previous morbid or surgical history.
Extraoral examination revealed a volume increase that compromised the area of the left mandibular body and ramus not previously studied by the patient.
There was no skin involvement and no lymphadenopathy was recorded.
There was no associated sensory compromise and the mandibular functional examination was normal.
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Intraoral examination revealed partial tooth loss due to the absence of left canines and lower molars, and an increased volume of surface abolished molars that compromised the body and ramus on the same side.
The mucosa that rectified it presented whitish areas, was painless to palpation and hard consistency.
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A panoramic radiograph was requested in which a mixed lesion of radio-opaque, bilocular and well-defined was observed, extending from the left root in its largest diameter to the lower mandibular branch 4cm.
Included in the lesion, canine dental germs, first and second left lower molar were observed.
The anterior edge of the branch, alveolar ridge and basilar edge were expanded.
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A CT scan was requested, showing a thinning of the cortical bones, mainly the vestibular one.
From this, a stereolithographic model was requested to plan definitive surgery.
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An incisional biopsy of the lesion was performed.
Histopathological examination stained with hematoxylin-eosin showed a lesion mainly constituted by a fibroblastic stroma with variable cellularity, containing multiple calcified structures of different sizes and irregular distribution.
The histopathological diagnosis was FO.
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With this diagnosis, definitive surgery was planned.
In the stereolithographic model a 2.4 reconstruction plate was modeled which extended at the basel edge level from the first right lower molar to the upper zone of the left mandibular ramus.
The jaw was exposed through a cervical approach and block resection of the compromised mandibular segment was performed considering as limits the borders of the tumor.
Later mandibular reconstruction was performed using a microvascularised fibular graft, which was adapted to the reconstruction plate and sectioned in three parts to facilitate its adaptation to the plate.
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In the postoperative management of the patient was used antibiotics and conventional analgesia in conjunction with revulsive and soft diet.
The latter lasted for one month.
After one year postoperatively, the patient underwent oral rehabilitation by placing implants or placement of implants on which a hybrid prosthesis was made.
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The patient is maintained with periodic clinical and radiographic controls.
Currently, after 5 years, she is in very good condition.
