PMC8413053_01
Preoperative views: (a) front view and (b) maximum mandibular opening at preoperation.
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fig1
The MID was 22 mm, and she experienced pain on attempting to open the mouth further (Figure 1).
Radiographic findings: (a) panoramic radiograph and (b) lateral projection of the temporomandibular joint.
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Radiography and CT images revealed displacement of the left and right temporomandibular articular heads due to fracture (Figures 2 and 3).
CT findings: (a) sagittal reconstruction of CT images and (b) coronal reconstruction of CT images. The bilateral condylar fractures were observed.
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fig3
Radiography and CT images revealed displacement of the left and right temporomandibular articular heads due to fracture (Figures 2 and 3).
Fabrication of the device. (a) A 4 mm thick ethylene vinyl acetate (EVA) sheet was cut into 2 x 6 cm pieces. (b) The surface of the sheets was softened using a burner, and blocks were created. (c) Lateral view of the device. (d) Top view of the device.
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fig4
The surface of the sheets was then softened using a burner, and blocks were created by stacking the sheets (Figure 4).
Mouth-opening training with the device. (a, b) The patient received instructions on how to insert the device and advance it in the direction of the molars.
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fig5
The patient received instructions regarding inserting the device, advancing it in the direction of the molar teeth to increase the mouth-opening, and avoiding overloading the teeth and crest (Figure 5).
Postoperative views: (a) front view, (b) maximum mandibular opening at postoperation, (c) occlusal view of maxilla, and (d) occlusal view of mandible.
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fig6
After 2 months, the MID before the training session was 35 mm and improved to 42 mm after training (Table 1 and Figure 6).