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J Oral Maxillofac Surg ; 68(7): 1628-30, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20417016

ABSTRACT

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.


Subject(s)
Alveolar Process/surgery , Mandible/surgery , Postoperative Complications/surgery , Temporomandibular Joint Disorders/surgery , Trismus/surgery , Carcinoma/radiotherapy , Carcinoma/surgery , Contracture/etiology , Contracture/surgery , Dental Implants , Denture, Partial , Functional Laterality , Humans , Jaw, Edentulous/rehabilitation , Male , Middle Aged , Mouth Neoplasms/radiotherapy , Mouth Neoplasms/surgery , Radiotherapy/adverse effects , Plastic Surgery Procedures/methods , Temporomandibular Joint Disorders/etiology , Treatment Outcome , Trismus/etiology
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