PMC5932510_01
Oral aperture. Pretreatment (a). Posttreatment, taken after ten months of follow-up (b).
CRID2018-8206381.001.jpg
PMC5932510_01_CRID2018-8206381.001.jpg
fig1
The maximum interincisal opening was only 20 mm (Figure 1(a)) (normal = 41-50 mm). The maximum interincisal opening is currently between 30 and 35 mm, approximately (Figure 1(b)).
(a) Panoramic view. (b) CT of the cranial coronal view. In the circle, it can be observed the coronoid apophysis markedly deviated to the left, maybe caused by the reported craniofacial trauma. (c) CT anteroposterior view of the skull. The cycle shows the reduced interarticular space of the left temporomandibular joint, compared with the right side. The arrow represents the evident left deviation of the coronoid apophysis.
CRID2018-8206381.002.jpg
PMC5932510_01_CRID2018-8206381.002.jpg
fig2
These images showed a reduction of the left articular condyle-glenoid fossae space width, with no evidence of condyle neck fracture, and a right deviation of first (odontoid process), second, and third cervical vertebrae, regarding the skull base, caused probably by the chin injury (Figure 2).
Different views of the intraoral appliance.
CRID2018-8206381.003.jpg
PMC5932510_01_CRID2018-8206381.003.jpg
fig3
The appliance was fabricated with soft polyester and fitted over the upper arch teeth's occlusal and incisal surfaces, with a 2-3 mm thickness, in order to create a precise occlusal contact with the opposite teeth (Figure 3).
Transversal slice CT taken in closed mouth (a) and in maximum oral aperture (b). The circles represent the second cervical vertebrae's body, in the centered position.
CRID2018-8206381.004.jpg
PMC5932510_01_CRID2018-8206381.004.jpg
fig4
New CT was taken, and it showed an evident improvement (Figures 4 and 5).
Current images of (a) left and (b) right condyles. Observe the adequate articular spaces.
CRID2018-8206381.005.jpg
PMC5932510_01_CRID2018-8206381.005.jpg
fig5
New CT was taken, and it showed an evident improvement (Figures 4 and 5).