UPDATE: Steve Jaffe, Oksana's rep, tells TMZ they have evaluated the photo and believe it is a "true and accurate photograph."
Sources connected with the dentist who treated Oksana Grigorieva tell TMZ the dentist believes "100% the photo circulating on the Internet has been altered."
We're told Dr. Ross Shelden is saying, "The nose is not hers. The lips are not right. It's not a true and accurate picture. It has definitely been altered."
We're also told the doctor says the teeth are in fact Oksana's, reaffirming that the teeth are intact, but one veneer was damaged and one was broken.
We have specific information about the dentist's observations ... and they raise serious questions about the nature of Oksana's alleged injury.