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Introduction:Mandibular coronoid process hyperplasia is an uncommon congenital or developmental temporomandibular joint disorder, characterized by elongation of the coronoid process, which may cause limited mandibular movement as a consequence of interference between the hyperplastic coronoid process and the medial surface of the zygomatic arch.Methods:Mandibular coronoid process hyperplasia commonly affects males in the second decade of life and the exact aetiology and pathogenesis is unknown. The condition can be uni- or bilateral. Progressive painless reduction in mouth opening is the main clinical finding and computed tomography is the most reliable imaging modality for confirming the diagnosis.Results:Surgical intervention involving coronoidectomy and long-term intensive postoperative physiotherapy is the treatment of choice for mandibular coronoid process hyperplasia with impingement on the zygomatic bone and limited mouth opening. However, surgically induced fibrosis and the tendency for mandibular coronoid process regrowth may cause relapse and renewed limited mouth opening. Vigorous physical therapy should therefore be initiated shortly after surgery.Conclusion:The purpose of this case report is to present the clinical and radiographic features of elongated mandibular coronoid process in an 18-year-old male with limited mouth opening, and to discuss the various surgical treatment modalities.

ObjectivesThe objective of the present systematic review was to assess the transverse skeletal and dental arch expansion and relapse after mandibular midline distraction osteogenesis with a bone-borne, tooth-borne or hybrid distraction appliance.Material and MethodsA MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 3rd of July, 2018 were included.ResultsTwo comparative and seven non-comparative studies characterized by high risk of bias fulfilled the inclusion criteria. Transverse mandibular widening was achieved with the different types of distraction appliance displaying a horizontal V-shaped opening with larger anterior transverse expansion declining progressively towards the posterior part of the mandible. Bone-borne and hybrid appliance facilitate more skeletal expansion compared with tooth-borne appliance, whereas comparable dental arch expansion was achieved with the different types of distraction appliance. Skeletal and dental arch relapse with the different type of appliance was limited and comparable. However, frequency of complications was higher with bone-borne appliance compared with tooth-borne or hybrid appliance.ConclusionsMandibular midline distraction osteogenesis with bone-borne, tooth-borne or hybrid distraction appliance is an effective treatment modality to correct severe transverse mandibular discrepancies, although the skeletal and dental arch expansion pattern was dissimilar with the different types of appliance. However, dissimilar evaluation methods, different outcome measures, various methodological confounding factors posed serious restrictions reviewing the literature in a quantitative systematic manner. Hence, well-designed long-term randomized controlled trials applying three-dimensional technology, patient-related outcome measures and an economic perspective are needed before definite conclusions can be provided.

Introduction:Skeletal Angle Class I patients with a severe dental Class II malocclusion are characterized by an unfavourable anterior-posterior relationship between the anterior dentoalveolar area and the skeletal base. Orthodontic alignment posing various treatment difficulties and surgical correction with bilateral sagittal split osteotomy may result in a compromised facial profile. Hence, anterior mandibular segmental distraction osteogenesis has been proposed as an alternative treatment modality for solving facial esthetics, anterior tooth crowding and an unfavourable relationship between the anterior dentoalveolar area and the skeletal base in skeletal Angle Class I patients with a severe dental Class II malocclusion. Limited skeletal relapse with predictable soft tissue changes have been documented in long-term studies. Thus, anterior mandibular segmental distraction osteogenesis seems to be a valuable and predictable surgical method for correction of selected cases of skeletal Class I patients with a severe dental Class II malocclusion.Case report:The purpose of this case report is to present the treatment of a 57-year-old female with a skeletal Angle Class I relation and a severe dental Class II malocclusion. Anterior mandibular segmental distraction osteogenesis as well as discussing the current knowledge about this treatment modality.Conclusion:The present case report illustrates that establishment of a harmonious relationship between the maxillary and mandibular arch in patients with a skeletal Angle Class I relation and a severe dental Class II malocclusion using anterior mandibular segmental distraction osteogenesis seems to be a predictable and applicable surgical method for selected cases and General Dental Practitioners, orthodontics and maxillofacial surgeons must have knowledge of this treatment modality.