A custom-made appliance for mandibular mobilization in children with limited mouth opening

Limited mouth opening can impact oral function and hygiene, necessitating surgical intervention. Adjunctive appliance therapy has been shown to improve postoperative outcomes. At The Hospital for Sick Children (SickKids), a customized Mandibular Opening Appliance (MOA) was developed to enhance jaw mobility post-surgery.

A retrospective chart review was conducted for seven patients who completed MOA therapy at our orthodontic clinic between 2021 and 2024, using data from patients' charts. Maximum incisal opening (MIO) was recorded pre-surgery, post-surgery, following MOA use, and follow-up.

Pre-surgical MIO ranged from 5 to 17 mm, with a mean of 8.8 ± 5.2 mm. Among the five patients with good to excellent compliance, final MIO ranged from 18 to 42 mm, representing a mean increase of 23.2 ± 9.2 mm (range: 13-36 mm). In contrast, two patients with poor compliance showed only minimal improvement (2 mm and 4 mm).

These findings demonstrate the efficiency of the MOA in improving MIO in compliant pediatric patients. Incorporating such appliances post-surgery shows potential for improving mandibular mobility and supporting long-term outcomes. Although a larger sample size is needed to strengthen the evidence, current results remain compelling and support refining appliance protocols for this patient population.