Reducing Mandibular Height to Increase Mouth Opening in Unreleasable Trismus

Purpose: We submit an alternative treatment for unreleasable trismus to increase the interincisal distance and allow adequate oral nutrition and masticatory function. Patient and Methods: The patient presented with severe trismus after receiving postoperation radiotherapy for oral carcinoma. We undertook radical release of the left-sided trismus, and covered the resultant soft tissue defect with an anterolateral thigh free flap, but the patient was only able to open his mouth an interincisal distance of 8 mm. The right mandible was accessed and the functionless residual teeth were extracted. Marginal mandibulectomy of the native mandible was performed. Results: Dental implants (POI, Kyocera, Japan) were inserted into the leveled right mandible. A bridge dental prosthesis was inserted and resulted in a final functional interincisal distance of 19 mm. Conclusion: We offer that leveling the native mandible to match the reconstructed side is a simple procedure that can be reasonably used as an alternative measure in a selected group of patients.