Coronoid process hyperplasia: an unusual cause of mandibular hypomobility.
A large number of disorders affecting the masticatory system can cause restriction of mouth opening. The most common conditions related to this problem are those involving the temporomandibular joint (TMJ) and the masticatory muscles, when facial pain also is an usual finding. Congenital or developmental mandibular disorders are also possible causes for mouth opening limitation, although in a very small prevalence. Coronoid process hyperplasia (CPH) is an example of these cases, characterized by an excessive coronoid process growing, where mandibular movements become limited by the impaction of this structure on the posterior portion of the zygomatic bone. This condition is rare, painless, usually bilateral and progressive, affecting mainly men. Diagnosis of CPH is made based on clinical signs of mouth opening limitation together with imaging exams, especially panoramic radiography and computerized tomography (CT). Treatment is exclusively surgical. This paper presents a case of a male patient with bilateral coronoid process hyperplasia, initially diagnosed with bilateral disk displacement without reduction, and successfully treated with intraoral coronoidectomy. It is emphasized the importance of differential diagnosis for a correct diagnosis and, consequently, effective management strategy.
Department of Prosthodontics, Bauru Dental School, University of São Paulo, Brazil. yuricosta@usp.br
Yuri Martins
YM
Costa
André Luís
AL
Porporatti
Juliana
J
Stuginski-Barbosa
Daniel Serra
DS
Cassano
Leonardo Rigoldi
LR
Bonjardim
Paulo César Rodrigues
PC
Conti
D000293:Adolescent; D006801:Humans; D006965:Hyperplasia; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology*; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000000981:diagnostic imaging