Abstract
Coronoid process elongation is a gradually progressive condition that presents with trismus. Although surgery is the first-choice treatment, perioperative treatment compliance is important for successful therapy, because postoperative mouth-opening exercise is mandatory in these patients. We report a case of bilateral coronoid process elongation in a 29-year-old woman with mental retardation and social withdrawal, which led to delayed diagnosis and treatment. The patient presented to the dentist for the first time in over a decade with pericoronitis of the left lower third molar. Examination showed bilaterally impacted mandibular third molars with impaired mouth opening. Based on three-dimensional computed tomography, she was diagnosed with bilateral coronoid process elongation and bilaterally impacted mandibular third molars. We performed bilateral coronoid process resection and bilateral mandibular third molar extraction under general anesthesia. Intraoperatively, we observed gliding motion of the bilateral temporomandibular joints, and her mouth opening capacity was 47mm. We introduced mouth-opening exercises 3 days postoperatively, which she temporarily vehemently refused to perform. However, we explained the importance of a consistent training regimen, and she continued it. Currently, the self-extraction volume of 40mm is maintained without any symptom of recurrence of coronoid process elongation.
