Key-words:
3D - fibrous dysplasia - histopathology - third dimension
Introduction
Fibrous dysplasia is an intraosseous bony lesion and most of the times recur. It is
very common lesion to be discussed in academics in dental and medical literature and
is familiar lesion among the clinicians too. It has been well explained in dental
literature through high-quality 2D images. However, readers cannot visualize its pathogenesis
and histopathology through such description in a life-like manner because the description
has always been of a slice of the biopsy. Histopathological aspects of all the lesions
in the literature have been explained, only with the help of 2D images. Therefore,
author has designed 3D images and video to recreate life-like tissue and to explain
the key events of its etiopathogenesis and histopathology, to be clearly understood
not only by dental and medical experts and students but also by patients.[[1]],[[2]],[[3]] Only few diseases have been explained in dental literature with the help of 3D
images and video so far.[[4]],[[5]],[[6]],[[7]],[[8]]
Methodology
Preliminary 3D images and videos [[Video 1]] on histopathological aspect of fibrous dysplasia were designed by using 3Dmax (Autodesk
Media and Entertainment) and Adobe premiere pro 5.5 software which is a video editing
software (Adobe Systems).[MULTIMEDIA:1]
Ethical approval was not considered as this manuscript is not patients based original
research. Instead it's an original article based on 3D animation and 3D images on
histopathological aspect of fibrous dysplasia using various softwares which has never
been reported yet.
Histopathological of fibrous dysplasia in 2 dimensions
Biopsy tissue shows numerous irregular, C-shaped trabeculae of woven bone, not connected
to each other, showing no relation to functional patterns, in a background of low
to moderate cellular fibrous connective tissue. Early lesions show more of fibrous
tissue whereas advanced lesions show more of bony trabeculae imparting the characteristic
“Chinese letter pattern.” The intervening fibrous connective tissue shows mononuclear
cells resembling fibroblasts and progenitor osteoblasts.[[3]]
Key events in the pathogenesis of fibrous dysplasia in the third dimension
-
Resorption of existing spongy bone - The spongy bone has been shown as interconnected
rods present between the two cortical plates. Resorption process has been shown as
disappearance of trabecular bone [[Figure 1]] and [[Figure 2]]
-
Spongy bone is replaced by highly cellular stroma - The resorbed spongy bone is then
replaced by highly cellular fibrous stroma which has been shown as cell-rich tissue
with plump-shaped fibroblasts [[Figure 3]]
-
Formation of immature bone - These young fibroblasts then lay down immature bone which
is curvilinear. All the bony spicules are equidistant from each other. It gives typical
Chinese script pattern [[Figure 4]].
-
Due to the proliferation of the lesion, the cortical plate shows expansion. All the
above events have been put together in a 3D animation video https://drive.google.com/file/d/16F_HXwHTqcgdjbbvxOssgruYMpN1Y3P_/view?usp=sharing
[[Video 1]].
Figure 1: 3D image shows spongy bone with (a) trabeculae and overlying osteoblasts (b)
Figure 2: 3D image showing disappearing spongy bone which is replaced by cellular fibrous tissue
Figure 3: 3D image showing spongy bone completely replaced by cellular fibrous stroma
Figure 4: 3D image showing new immature bone formation in the form of Chinese script pattern
3D animation videos on histopathological aspects of all lesions should be made available
on multimedia for better understanding for students in a life-like manner and to discontinue
the trend of rote learning among the students.
