Mouth Opening Retaining Appliance after Coronoidotomy for the Treatment of Trismus: Effects on Pain during Postoperative Training and Maximal Extent of Mouth Opening

Kazuya Yoshida*

Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, Japan

^*Correspondance to: Kazuya Yoshida 

 PDF  Full Text DOI: 10.25107/2474-1647.2737

Abstract

Background: Coronoidotomy, the surgical resection of the coronoid process, is often successfully performed in patients with severely limited mouth opening related to coronoid process hyperplasia, temporomandibular joint ankylosis, oromandibular dystonia, and masticatory muscle tendonaponeurosis hyperplasia. Although postoperative mouth opening training is important, it is significantly painful and considered a patients’ burden. Methods: To reduce severe pain related to the mouth opening exercise and produce better outcomes, silicone-made mouth opening retaining appliances were directly fabricated in the patients’ mouth. Thirty-four patients with limited mouth opening were recruited in this study. The patients were randomly assigned into two groups, with and without the appliance. All patients underwent bilateral coronoidotomy and masseter muscle stripping. The patients’ pain scores were compared statistically during the mouth opening training, and postoperative maximal interincisal mouth opening was measured at the first, third, seventh, and tenth days of the training between the groups. Results: After the surgical procedures, the mean maximal distance of mouth opening significantly increased from 14.8 mm to 45.0 mm at discharge. The maximal interincisal distance was significantly larger at the first and third days of the mouth opening training in the group with the appliance than in the group without the appliance. Pain during the mouth opening training was significantly higher at the first, third, and seventh days in the group without the appliance than in the group with the appliance. Conclusion: The oral appliance can reduce postoperative pain related to mouth opening training and produce better outcomes in patients undergoing coronoidotomy for trismus.

Keywords

Oral appliance; Coronoidotomy; Limited mouth opening; Mouth opening training; Masseter muscle

Cite the article

Yoshida K. Mouth Opening Retaining Appliance after Coronoidotomy for the Treatment of Trismus: Effects on Pain during Postoperative Training and Maximal Extent of Mouth Opening. Clin Surg. 2020; 5: 2737.