New technologies in oral radiology as a diagnostic aid for monostotic fibrous dysplasia: a review

Monostotic fibrous dysplasia is a benign asymptomatic lesion that affects only one bone, which is replaced by amorphous connective tissue. Clinically there is an increase in the volume of the affected area, which is observed by imaging as a radiopaque area with diffuse non-corticalized limits capable of expanding to neighboring structures, and it is histologically evidenced as "resembling Chinese characters". The lesion is seen as a radiopaque image with diffuse borders in conventional or digital radiography, while cone beam computed tomography identifies the exact location and extension of an isodense, mixed or hyperdense image of non-corticalized edges. Magnetic resonance imaging is also used when the lesion involves soft tissues or nerves, and bone scintigraphy is performed in order to systemically observe bone quality. The objective of this article was to describe the new technologies in oral radiology for the diagnosis of monostotic fibrous dysplasia and the importance of the current imaging methods in achieving an adequate diagnosis. These techniques range from conventional radiography to bone scans, which provide images of higher quality, clarity and better precision with less invasive techniques to the patient. This review of the literature helps to expand the knowledge of dental professionals in relation to the clinical and imaging characteristics of monostotic fibrous dysplasia.

Clinical and translational pharmacological aspects of the management of fibrous dysplasia of bone

Fibrous dysplasia (FD) is a genetic, noninheritable rare bone disease caused by a postzygotic activating mutation of the α subunit of the stimulatory G‐protein causing increased abnormal bone formation leading to pain, deformity and fractures. To date, no cure has been identified for FD/McCune–Albright syndrome (MAS) and treatment is symptomatic and aimed at decreasing pain and/or local bone turnover. Various drugs have been used to achieve clinical improvement in FD/MAS patients including bisphosphonates and denosumab, however further translational studies are also warranted to address unresolved pathophysiological issues and explore novel pharmacological targets for the management of FD/MAS.

In this article, we review literature on the medical treatment of FD/MAS, discuss the unresolved pathophysiological issues and explore novel pharmacological targets for the management of FD/MAS.