Dental extraction protocol in a patient with fibrodysplasia ossificans progressiva

AbstractFibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by heterotopic bone formation within skeletal muscles, ligaments, tendons, and other connective tissues that affects one in 2 million people. By 10 years of age, patients with FOP frequently experience fusions within the axial skeleton, with subsequent ossifications throughout the appendicular skeleton. Any type of trauma or inflammatory process can lead to heterotopic ossification. These ossifications can affect the muscles of mastication, limit mandibular movement, and restrict inter-incisal opening. This case reports a 22-year-old male patient with FOP who had poor oral intake because of a 0-mm incisal opening and no interdental or maxillomandibular spacing to allow oral feeding. The patient was referred to our department for unilateral molar extractions to help facilitate oral tube feedings. The procedure was completed in the main operating room under general anesthesia using standard instruments and a surgical drill. The patient underwent routine postoperative healing, has 2.5 cm of posterior maxillomandibular spacing, and reports improved oral intake. This case illustrates that patients with FOP and a poor nutritional status as a result of limited, or nonexistent, mandibular movement may undergo dental extractions under general anesthesia to help facilitate oral intake