Prolonged Mandibular Hypomobility Patient with a “Square Mandible” Configuration with Coronoid Process and Angle Hyperplasia

ABSTRACTThe objective of this study was the surgical management of chronic severe mandibular hypomobility patients associated with square mandible morphology with coronoid process and angle hyperplasia, and one-year follow-up data is reported. Ten patients were studied. All patients were female and had a history of gradual severe jaw hypomobility. Clinical findings were similar to those of a “closed lock” patient. However, the facial appearance in these patients showed a characteristic square mandible facial configuration. Coronoid process thickening and overgrowth of the mandibular angle was evident in the radiographic findings. Diagnostic imaging scarcely depicted any disk derangement, but a severely limited jaw opening was noted in spite of acceptable excursive jaw movements. Bilateral coronoidotomy or coronoidectomy was done initially, and then masseter muscle stripping via the intraoral approach. After successful reduction of jaw hypomobility, a selective mandibular anglectomy was completed. Physical...