[Fibrous dysplasia: management of a severe case of pseudo-leontiasis ossea]

We report the case of a 75-year-old woman who consulted for suppurative gingivitis and maxillary deformation with slow progression and associated severe joint disorder. The patient suffered both esthetic prejudice and functional impairment. Clinical signs and radiographic findings suggested the diagnosis of fibrous dysplasia, in its leontiasis ossea form, rarely reported in the literature. Primum non nocere guided our management. Abstention, a simple remodeling resection, or extensive resection and reconstruction would have been inappropriate in this elderly patient. We opted for an orthognatic attitude in spite of the vascular risk inherent in the orthodontic preparation and the osteotomy on an abnormal dystrophic bone. Outcome was satisfactory.