Limited mandibular movement: causes and treatment

Limited mandibular movement is a challenging clinical problem. A variety of treatment modalities have been described to permit planning of an individual course of treatment for each patient.     

Fibrodysplasia ossificans progressiva. An unusual cause of restricted mandibular movement

A 9-year-old girl is presented who was initially misdiagnosed and finally diagnosed with fibrodysplasia ossificans progressiva only after presentation with progressive limitation of her mouth opening. The clinical, histopathological, and molecular biological aspects of this uncommon disorder will be discussed. Furthermore, dental and surgical guidelines will be described.     

Bilateral coronoid hyperplasia resulting in severe limitation of mandibular movement. Report of a case

A case of bilateral coronoid hyperplasia with limitation of mandibular motion in a female patient has been presented. Her symptoms began to develop around the age of 44. We believe that this is the first case to be reported in a female. Also, in all other reported cases symptoms began to develop around the onset of puberty. The literature has been reviewed with specific reference to the etiology of bilateral coronoid hyperplasia. This case brings the total number of reported cases to twenty-two. We hope that if similar cases are identified in female patients the practitioners will report them promptly. Only in this way will we be in a better position to understand the etiology of bilateral coronoid hyperplasia with special reference to heredity.     

The range of functional mandibular movement in bruxists. 2. Materials and method

Part 2 of this investigation of the range of functional mandibular movement of bruxists consists of the examination (via history, questionnaire and clinical observation) and recording of the mandibular movement of a variety of subjects, non-bruxist and bruxist.     

Ectopic movement of an unerupted mandibular canine.

A case history has been given with the radiographic evidence of the migration, during development of an unerupted mandibular canine from its normal position. In a 30-month period the canine assumed a horizontal position and moved to a site that was apical to the mandibular incisors, still in the confines of the cortical plates. Because erratic movements of unerupted teeth cannot be anticipated, it would seem wise to defer the elective removal of permanent teeth during the mixed dentition stage until the clinician is assured of a normal eruption pattern of the succedaneous teeth.     

An unusual mandibular dislocation

An unusual case of posterior dislocation of the mandibular condyle is reported. The difficulties that may arise in treatment of such injuries are discussed briefly.     

An unusual medieval mandibular pathology

A medieval mandible with an unusual bilateral periosteal reaction, probably related to chronic inflammation or infection, is presented.     

Patients with unusual requests for extractions 2. Mental incompetency and psycho-pathologic causes

If there is no indication for tooth removal purely based on dental criteria, but the patient requests for removal due to fear of dental treatment, or because of a mental disorder such as posttraumatic stress disorder, a somatoform pain disorder or a disorder of body image perception, then the question is whether the patient is mentally competent to make this decision. In case of a tooth removal request on psychopathologic basis, a dentist has to refuse to carry out such treatment, but he should make an effort to help or guide the patient in some other way.     

Mucogingival changes resulting from mandibular incisor tooth movement.

This study involved a cephalometric analysis of 1,150 fully treated orthodontic cases evaluated by Kodachrome slides, plaster casts, and cephalometric films to determine changes in the width of keratinized gingiva relative to lower incisor tooth movement and to ascertain the incidence of mucogingival problems in orthodontic patients. It was apparent that in a small percentage of cases visible mucogingival changes occurred and could be statistically correlated with the magnitude and direction of tooth movement. In this group of patients 1.3 percent (sixteen) showed a decrease in the width of keratinized gingiva with either minimal movement or some labial movement of the mandibular incisors; 0.69 percent (eight) had an increase in keratinized gingival width concomitant with significant lingual positioning of the lower incisors. The salient point to be made is that with an initial minimal or inadequate width of keratinized gingiva (0 to 2 mm.), mandibular incisor tooth movement over a period of treatment could significantly affect the final quality of gingival health in the critical mandibular anterior region.     

An unusual type of mandibular fracture

Fracture of the mandible is a common maxillofacial injury. A case is presented of an unusual type of mandibular fracture.     

An unusual complication of mandibular distraction

BACKGROUND: The authors present an unusual complication of mandibular distraction in a child with the curious condition of multiple pterygium syndrome is presented. CASE REPORT: The patient was a Caucasian male with severe pterygia in his neck. As a result of his limited mouth opening and restricted upper airway leading to obstruction, he underwent lengthening of his mandible by distraction, which significantly improved his breathing. During his follow-up, it was observed that an unusually elongated permanent molar was present in an abnormal position. CONCLUSION: This case highlights the need to carefully plan the sites for osteotomy and the potential for damage to the developing permanent dentition in young children.