This is a 38-year-old male patient, who reported limited mouth opening, who noticed that it began at 18 years of age and has progressed.
Totally asymptomatic, it already causes difficulty to eat.
In addition, it courses with different intraoral carious foci that the dentists he has visited have declared impossible to treat due to the reduced oral opening.
The patient refers multiple treatments with different specialists trying to improve this oral opening, with physical therapies and jaw exercises, which have been totally ineffective.
When the first examination was performed, the patient presented a maximum mouth opening of 16 mm, which did not change when forcing it, the patient had a panlongoramic radiograph and an evident CT scan above the level of the arch.
Once diagnosed as HPC, it was decided to perform bilateral coronoidectomy through an intraoral approach, taking place during the transoperative period with a maximum oral opening of 40 mm.
1.
Once the 3 postoperative days have passed, physical therapies are initiated with mouth opening exercises and tongue support, progressing well during the first week (21 mm of maximum mouth opening).
It then presents a decrease in oral opening being critical (6 mm maximum mouth opening).
It was decided to use functional orthopedic appliances, with the use of Spring-Bite, with an interval of 10 min of 4 to 5 times a day, obtaining an oral opening of 30 mm at 30 days.
The use of this appliance continued for 6 months.
