Reducing mandibular height to increase mouth opening in unreleasable trismus.

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.