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Published on: March 1, 2015
Reducing mandibular height to increase mouth opening in unreleasable trismus
Chi-Ying Tsai1, Rozina S Ali, Fu-Chan Wei
1Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan.
Purpose:
We submit an alternative treatment for unreleasable trismus to increase the interincisal distance and allow adequate oral nutrition and masticatory function.
Patient And Methods:
The patient presented with severe trismus after receiving postoperation radiotherapy for oral carcinoma. We undertook radical release of the left-sided trismus, and covered the resultant soft tissue defect with an anterolateral thigh free flap, but the patient was only able to open his mouth an interincisal distance of 8 mm. The right mandible was accessed and the functionless residual teeth were extracted. Marginal mandibulectomy of the native mandible was performed.
Results:
Dental implants (POI, Kyocera, Japan) were inserted into the leveled right mandible. A bridge dental prosthesis was inserted and resulted in a final functional interincisal distance of 19 mm.
Conclusion:
We offer that leveling the native mandible to match the reconstructed side is a simple procedure that can be reasonably used as an alternative measure in a selected group of patients.
