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Jacob’s disease is characterized by osteochondroma arising from the coronoid process of the mandible. Patients usually present with limitations of mouth opening and cheek prominence. Computed tomography of facial bones with three‑dimensional reconstruction was considered the gold standard for diagnosis. Management was principally surgical which involved the removal of the coronoid process either by intraoral or extraoral approach. Postsurgical mouth‑opening exercises are considered important for maintaining the obtained results. [ABSTRACT FROM AUTHOR]

Purpose: The double coronoid process (DCP) is a very unusual feature in patient. The literature, which briefly describes just only one case. Being this a very unusual feature, the aim of the paper is to describe the finding, discuss the anatomic, radiological, and clinical characteristics of a DCP. Methods: A 61-year-old-woman with no significant medical history, extraoral and intraoral examination was unremarkable. Following panoramic radiography (PR) for assessment of periodontal support and pre-implant planning suspicious radiopaque area in the mandibular notch on the left side was observed. Cone-Beam Computed Tomography (CBCT) and Magnetic resonance imaging (MRI) were subsequently performed. Results: No signs and symptoms of syndromes or medical records with a relevant contribution to the DCP existence and the patient denied any type of facial trauma. CBCT image showed the structure found on the PR was indeed a DCP and it was not superimposed on the mandibular notch area, MRI was performed to investigate soft tissue components and temporomandibular joint (TMJ) or other alterations. Conclusion: DPC is extremely rare with the only case reported in the literature within the same comparison parameters. In this case images revealed the muscles, articular surfaces and articular disc were well preserved, and no other alterations were found. [ABSTRACT FROM AUTHOR]

Background: Mass fatality incidents occur due to environmental, medical, vehicle, industrial, or terrorist events that can involve large numbers of victims. Identification of these victims is of utmost importance in these situations. Cone-beam computed tomography (CBCT) may be helpful in some forensic contexts, offering several advantages for postmortem forensic imaging. Aim: The research study aims to evaluate the sexual dimorphism of the maxillary sinus and inter coronoid distance to estimate sex by using CBCT. Materials and Methods: In 40 CBCT scans of 20 males and 20 females, maxillary sinuses height, width and inter coronoid distances of mandible were measured for forensic analysis. In high quality, reconstructed images of bilateral maxillary sinuses, height, and width were measured, and in mandible, inter coronoid was measured in axial view. Results were tabulated and analyzed using an unpaired t-test and discriminant function analysis used to compare differences in the measured parameters between males and females. Results: Mean values of inter coronoid in males and females are (♂ =88.1, ♀ =78.1). The maxillary sinus right side height and width (♂ =32.2, ♀ =24.6) (♂ =19.7, ♀ =19.6) left side height and width (♂ =32.7, ♀ =23.6) (♂ =18.1, ♀ =17.8), respectively. A statistically significant (P < 0.05) difference was found in maxillary sinus and inter coronoid distance between males and females. Results showed significantly larger dimensions of maxillary sinus and inter coronoid distance in males compared to females. The correct predictive accuracy rate of sex determination was 100% in females and 90% in males with overall accuracy of 95%. Conclusion: The present study showed the importance of maxillary sinus dimensions and inter coronoid distance in sex estimation using cone-beam computed tomography in forensic medicine. [ABSTRACT FROM AUTHOR]

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We describe two cases of giant cell arteritis where involvement of the superficial temporal artery and maxillary artery were demonstrated using colour doppler ultrasonography. Maxillary artery involvement is responsible for the symptoms of jaw claudication and toothache, and even headaches might be due to the involvement of the middle meningeal artery which is a branch of the maxillary artery. The maxillary artery has been difficult to visualise until now. There are international consensus definitions of ultrasonographic abnormalities seen in the superficial temporal artery affected by giant cell arteritis. We have used those definitions to demonstrate hypoechoic changes in the maxillary artery affected by giant cell arteritis. The maxillary artery can be visualised in the infratemporal fossa from an echo window between the condylar and coronoid processes of the mandible. This is the first proof of concept evidence that maxillary arteries can be visualised using bedside ultrasonography in giant cell arteritis. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the morphological types of the coronoid process. This study is to determine the variation in shape in the coronoid process of the mandible.Materials and Method:In the study, 30 unsexed dry human adult mandibles were examined from the Department of Anatomy, Saveetha Dental College and Hospitals. They were properly analyzed and the morphology of coronoid processes of each mandible was noted and tabulated. Results: The results show that the prevalence of mandibles with coronoid processes having hook shaped (48.33%) was the most common. This was then followed by triangular shaped (31.66%) and the least common of all is the round shaped coronoid process (20%). Conclusion: Knowledge of the morphological shapes of the coronoid process is useful for the maxillofacial surgeon during reconstructive surgeries. The mandibular coronoid process has been used as a donor site for sinus augmentation. The shape of the coronoid process is also useful in anthropological studies and in forensic dentistry. [ABSTRACT FROM AUTHOR]

Vertical malocclusion is a developmental condition, resulting from complex interactions among multiple etiological factors during the growth period. As a tricky dentofacial deformity clinically, long-face (LF) morphology is characterized by excessive vertical facial growth with severe disarrangement of jaws and teeth. Since the improvement of LF patients on facial profile and occlusion is often difficult and lacks long-term stability, it becomes important to unravel the etiology of LF pattern formation for early prevention and treatment. In the current studies, we identified a transgenic mouse model that exhibited a dysplastic coronoid process and LF morphology. Although the mutant mice exhibited jaw structures and occlusion comparable to controls at birth, they all acquired typical LF morphology with anterior open bite during postnatal growth, resembling clinical features of the selected skeletal class III patients. Since the coronoid process provides an insertion site for the temporalis attachment, we examined the initial development and differentiation of the temporalis and found identical results in both control and mutant mice before E17.5 when the temporal muscle makes attachment to the coronoid process. However, thereafter, we observed altered orientation and reduced size of the cross-sectional area of the temporalis in mutant mice, which persisted to the weaning stage. Biomechanical analysis and simulation modeling further support the idea that altered morphology of the coronoid process may impair the efficiency of the vertical temporalis contraction and appears to correlate with LF formation. Consistently, we present evidence that a dysplastic mandibular coronoid process was also seen in some human patients with skeletal III LF morphology. Taken together, the results presented in this study establish an association of the craniofacial bony structures with vertical patterning, which will have implications in earlier prediction for clinical precaution and intervention. [ABSTRACT FROM AUTHOR]

The Batrachosauroididae are an enigmatic group of salamanders known from the Cretaceous and Tertiary of North America and Europe. In Europe, the family is known only by two species of the genus Palaeoproteus. The genus has limited distribution in Western and Central Europe. In the present paper, we describe a new species, Palaeoproteus miocenicus, from the early late Miocene (11–9 Ma) of Austria and Ukraine, representing the youngest record of the family Batrachosauroididae from the Neogene of Europe. The new species differs from the Paleogene representatives of the genus by 12 characters, including large body size, the long anterior extension of the Meckelian groove and the size and shape of the odontoid process on the dentary. The µCT scanning of bones of the new species revealed novel features (e.g. anterior extension of Meckelian groove, interconnected network of canals and small cavities in atlas) observable only in this species. P. miocenicus inhabited aquatic environments, which existed under wet climatic conditions with mean annual precipitation higher than 900 mm. The new species expands the temporal range of the genus by at least 30 million years and enlarges the palaeogeographic distribution of the genus into Eastern Europe. [ABSTRACT FROM AUTHOR]

In a sinus lift procedure, bone grafting is usually performed concomitantly. The mandibular coronoid process is an advantageous donor site for autogenous bone grafts. A clinical case of sinus bone grafting using the coronoid process of the mandible is presented here, along with the surgical technique to accomplish this procedure. A successful outcome was obtained in the patient, who experienced no functional problems. [ABSTRACT FROM AUTHOR]

Aim: To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Methods: Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Results: Coarse crepitus on opening/closing (odds ratio [OR] ≥ 3.12), on lateral excursions (odds ratio ≥ 4.06), and on protrusion (OR ≥ 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR ≥ 2.95) and so did increasing age (OR ≥ 1.03 per year) and the female gender (OR ≥ 2.36). Maximal assisted opening and maximal opening without pain (< 40 mm) was associated with a posterior condyle-to-articular tubercle position (OR ≥ 2.60). No other significant associations were observed. Conclusion: Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening. [ABSTRACT FROM AUTHOR]

This article reports a case of retrieval of an ectopic molar medial to the coronoid process of the mandible that caused chronic discharging of a sinus into the mouth and recurrent facial swelling. Possible origin of the tooth and surgical approaches are discussed. [ABSTRACT FROM AUTHOR]

Aims: Arthrogryposis multiplex congenita (AMC) is characterized by congenital contractures and joint deformities, but there are only a few reports of temporomandibular joint (TMJ) involvement. The objective of this investigation was to study the cause of limited mouth movement in this disease. Materials and Methods: Four individuals from a family affected by AMC over 5 generations were examined clinically and by magnetic resonance imaging (MRI) and 3-dimensional computerized tomography (3D-CT). Results: The CT scans of the 4 individuals showed hyperplasia of the coronoid process protruding into the infratemporal fossa in 2 of them and cranially to the zygomatic arch in the other 2; the hyperplasia was associated with mechanical limitation of the mouth opening. The MRI showed a disc displacement with reduction in 1 patient and a disc displacement without reduction in another; disc displacement could not be evaluated because of the limited mouth opening in the other 2. The condyle-disc complex of these last 2 individuals could only rotate. The MRI on T2- weighted images showed disc hyposignal in all cases but no alterations in the masticatory muscle tissue. The pedigree of the family suggests an autosomal dominant form of inheritance. Conclusions: The restriction of mouth opening in the 4 individuals affected by AMC was likely due to osseous dysplasia. [ABSTRACT FROM AUTHOR]

The mandible serves as an important structure in relation to mastication as all the muscles of mastication are attached to it. The Coronoid process is the anterior bony projected part of ramus of mandible giving attachment to two important muscles of mastication. The aim of our study was to observe the variation in the size of coronoid process in relation to its side (laterality), shape, age and sex. The material for this study comprised of 80 (160 sides) dry human mandibles. The age and sex differentiating criteria were detailed in materials and methods. The size of coronoid process was found to be approximately 1.5 mm longer on the right side than on the left side; 0.01 mm longer in males than females and 0.01 mm longer in dentulous than in edentulous. Triangular coronoid process was found to be the longest followed by round and then hook shaped. Male hormonal impact on muscle growth, bone remodeling and psychology probably lead to enhanced functional stress on mandible due to mastication as compared to that in females. Pterygoid muscles are involved mainly in side to side movement and Masseter-Temporalis (M-T) component in the robust vertical thrust during mastication for crushing. The condyloid process is for pterygoid and M-T-Coronoid Lever complex engenders the proportionate sexual dimorphism as observed in this study. Poor crushing activity in the edentulous is also corroborated in our observation.This comparative study is a pioneer study which will be beneficial for the Anthropologists, Forensic scientists and Reconstructive surgeons. [ABSTRACT FROM AUTHOR]

Purpose: Arthroscopic reduction and internal fixation for coronoid process fractures has been proposed to overcome limitations of open approaches. Currently, arthroscopy is most frequently used to assist insertion of a retrograde guide wire for a retrograde cannulated screw. The present anatomical study presents an innovative arthroscopic technique to introduce an antegrade guide wire from an accessory anteromedial portal and evaluates its safety and reproducibility.Methods: Six fresh-frozen cadaver specimens were obtained and prepared to mimic an arthroscopic setting. The coronoid process was localized and a 0.9 mm Kirschner wire was introduced from an accessory anteromedial portal, located 2 cm proximal to the standard anteromedial portal. At the end of the procedure, a lateral radiograph was taken to verify the Kirschner wire position and open dissection was conducted to evaluate possible damage to neurovascular structures.Results: The Kirschner wire was drilled without complications in the coronoid process of all six specimens. Damage of the brachial artery, the median nerve, and the ulnar nerve did not occur in any specimen. A corridor between the brachialis muscle, the median intermuscular septum, and the pronator teres could be identified as suitable for the wire passage.Conclusion: This study presents a safe and reproducible technique combining the possibility to introduce a guide wire from the anteromedial part of the coronoid, under direct visual control, with a completely arthroscopic approach. This wire can guide the introduction of a retrograde cannulated screw from the dorsolateral ulna to the tip of the coronoid. This new arthroscopic approach permits to obtain improved visual control over coronoid process fixation, without endangering neurovascular structures. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the usefulness of the paramagnetic gadoliniumcontaining contrast agent, diluted 1:800, in evaluations of pathological changes in the canine elbow joint. The experiment was performed on 6 large breed dogs of both sexes with a body weight of 25 to 40 kg. Thoracic limb lameness and pain in the elbow joint area were observed in all patients. The animals were subjected to standard physical examinations, radiography and low-field magnetic resonance imaging scans with the use of a contrast agent. The Spin Echo T1 dorsal sequence as well as 3D SST1 transverse and XBONE T1 transverse sequences were highly effective in diagnosing osteochondritis dissecans (OCD) of the medial humeral condyle. Degenerative changes and the fragmented coronoid process (FCP) of the ulna were very well visualized by High Resolution Gradient Echo, XBONE T2 and Spin Echo T1 sequences in the sagittal plane. The administration of the gadolinium contrast agent, diluted 1:800, to the elbow joint cavity enhances the diagnostic value of magnetic resonance images in evaluations of medial compartment disease, in particular fragmentation of the medial coronoid process. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the location and the shape of the mandibular lingula in skeletal class I and III patients using panoramic radiography and cone-beam computed tomography. Materials and Methods: The sample group included 190 skeletal class I patients and 157 class III patients. The location of the lingula in relation to the deepest point of the coronoid notch was classified into 3 types using panoramic radiographs. The shapes of the lingulae were classified into nodular, triangular, truncated, or assimilated types using cone-beam computed tomographic images. The data were analyzed using the chi-square test. Results: The tips of the lingulae were at the same level as the coronoid notch in 75.3% of skeletal class I patients and above the coronoid notch in 66.6% of class III patients. The positions of the lingulae in relation to the deepest point of the coronoid notch showed statistically significant differences between class I and class III patients. The most common shape was nodular, and the least common was the assimilated shape. Although this trend was not statistically significant, the triangular shape was more frequently observed in class III patients than in class I patients. Conclusion: The locations and the shapes of the mandibular lingulae were variable. Most of the lingulae were at the same level as the coronoid notch in skeletal class I patients and above the coronoid notch in skeletal class III patients. The nodular and assimilated-shaped lingulae were the most and the least prevalent, respectively. [ABSTRACT FROM AUTHOR]

Background: This study aimed to report the radiographic findings and surgical outcomes of anteromedial facet (AMF) fracture of the ulnar coronoid process and to suggest an optimal approach.Methods: In this retrospective study, 20 consecutive patients with unilateral AMF fracture of coronoid process were surgically treated and divided into two groups without (group A) and with (group B) additional proximal ulnar fractures in equal case number. Time from injury to surgery averaged 4.38 ± 2.56 weeks. Mayo Elbow Performance Score (MEPS) and Shortened Disability of the Arm and Shoulder and Hand (quickDASH) score were used for functional evaluation. Cohen kappa coefficient (kappa) analysis was used to determine interobserver reliability on a radiographic reading.Results: All cases had a mean follow-up of 2.3 years. MEPS at 2 years averaged 87.75 ± 12.51; quickDASH, 7.05 ± 6.19. A significantly higher MEPS was found in subtype 3 than in subtype 2 (p = 0.036) and in group B than in group A (p = 0.020). Significantly lower quickDASH cores were found in group B than in group A (p = 0.011). Kappa analysis showed moderate agreement in the O'Driscoll classification (kappa = 0.56) and substantial agreement in categorization of the additional proximal ulnar fractures (kappa = 0.76).Conclusions: Additional proximal ulnar lesions were considered an integral part of varus posteromedial rotatory instability and required further categorization in the management of AMF fractures. Significantly better functional outcomes were achieved when those lesions were fully addressed. [ABSTRACT FROM AUTHOR]

The biceps brachii - brachialis muscles has attachment on the medial coronoid process (MCP) and proximal radius. It is considered that medial coronoid disease (MCD) can be caused by biceps brachii - brachialis muscle generated force to MCP. Computed tomography data from 31 dogs were analysed. The aim of this study was to compare biceps brachii - brachialis muscle volume and maximum cross-sectional area (mCSA) between clinically normal dogs to dogs with a MCD. Results showed that in dogs with MCD, biceps brachii - brachialis muscle volume and mCSA is smaller than in clinically normal dogs and therefore the generated muscle force cannot be considered as the main or accompanying cause of a MCD. [ABSTRACT FROM AUTHOR]

The treatment strategy and surgical indication for coronoid process fractures are not clear. Many methods of surgery have been described. We report on the use of arthroscopic osteosynthesis for this type of fracture. This method is minimally invasive and effective for confirming the reduction, and it is advantageous for postoperative pain and early recovery after surgery. [ABSTRACT FROM AUTHOR]

Objectives: Among the diagnostic features of the Neandertal mandible are the broad base of the coronoid process and its straight posterior margin. The adaptive value of these (and other) anatomical features has been linked to the Neandertal's need to cope with a large gape. The present study aims to test this hypothesis with regard to the morphology of the coronoid process. Materials and Methods: This admittedly simple, intuitive hypothesis was tested here via a comparative finite-element study of the primitive versus modified state of the coronoid process, using two-dimensional models of the mandible. Results: Our simulations demonstrate that a large gape has an unfavorable effect on the primitive state of the coronoid process: the diagonal, almost horizontal, component of the temporalis muscle resultant (relative to the long axis of the coronoid process) bends the process in the sagittal plane. Furthermore, we show that the modification of the coronoid process morphology alone reduces the process' bending in a wide gape increasing the compression to tension ratio. Discussion: These results provide indirect evidence in support of the hypothesis that the modification of the coronoid process in Neandertals is necessary for enabling their mandible to cope with a large gape. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the sexual dimorphism in the mandibles of Jordanians and derive a population specific equation for sex prediction. The employed sample comprised 270 cone beam computed tomography (CBCT) images of Jordanians (147 males and 123 females) aged 27-55 years. The images were rendered to 3D surface models, using customized software that provided various views for each mandible, on which measurements made of nine parameters (ramus height, right and left coronoids height, mandibular length, gonial angle, Intergonial breadth, Intercondylar breadth, mental and mandibular foramena) for the analysis of sex identification. The collected data sets were treated statistically using the Statistical Package SPSS version-21. Canonical discriminant function analysis was used to specify a parameter or combination of parameters that best separate the two sexes. Stepwise analysis together with leave-one-out classification procedure was applied (utilizing the Wilks lambda method), which identified six parameters that formed the best combination most precisely predicting sex. It also identified the predictors' coefficients from which a predictive equation for the Jordanian population was derived. The discriminant function group centroid discriminant scores for males and females and the sectioning cut-score were also defined. According to the equation, the function score for any set of measurements that is above the cut score is probably for a male individual whereas a score that was below the cut score is probably for a female subject. [ABSTRACT FROM AUTHOR]

Objective We wanted to evaluate the three-dimensional (3D) mandibular growth of Sprague-Dawley rats from 4th to 16th postnatal weeks with periodic and live micro-computed tomographic scanning. Design Twenty Sprague-Dawley rats were used for micro-CT scanning from 4th to 16th postnatal weeks. After 3D reconstruction of rat mandible, we performed the linear and angular measurements and the superimposition of the 3D models to evaluate the mandibular growth of rat. Results The results showed that the growth direction of the condylar and coronoid regions was superior primarily and posterior secondarily, while the condyle had minimal lateral growth. Moreover, the angular region was growing mainly toward the posterior and lateral direction, while the body and symphysis maintained small, incremental anterior-posterior growth. Conclusions We could evaluate the amount, rate, and direction of growth using the mandibular skeletal unit. Some reference points and measurements were more relevant in properly characterizing 3D growth of the mandible. Their growth rates were the greatest between 4th and 8th postnatal weeks, a period which seems most appropriate for studies of rat mandible growth. [ABSTRACT FROM AUTHOR]

Using museum materials and recently trapped specimens of field voles (Microtus agrestis (Linnaeus, 1761)) from Lithuania and Estonia, we assessed temporal and latitudinal trends in body and skull size, comparing the periods 1980-1996 and 2014-2016. We measured four body and 23 skull characters, size-adjusting them using the geometric mean procedure. A pronounced decrease in the size of M. agrestis was noted in Estonia, where 23 out of 27 adjusted body and skull characters had decreased by up to 21.9%, with only the tail length, hind foot length, maximum height of mandibula excluding coronoid process and coronoid height of mandibula increasing significantly. Decreases were less marked in voles from Lithuania - most pronounced were a 6.1% decrease in adjusted body length, an 11.6% decrease in adjusted length of the braincase, a 3.85% decrease in the breadth of the braincase, measured at the widest part, a 2.9% decrease in condylobasal skull length and a 2.2% decrease in the height of the braincase. The coronoid height of the mandibula of Lithuanian individuals showed an 8.4% size increase. In both countries, the confounding effect of sex on the size changes of M. agrestis from 1980 to 2016 was much smaller than the effect of time period. Concluding, voles in Estonia became significantly smaller, while changes in the measured characters in Lithuania were heterogeneous. [ABSTRACT FROM AUTHOR]

Objective: Coronoid process hyperplasia (CPH) of the mandible is a rare condition that can be defined as an abnormal bony elongation of histologically normal bone with the symptoms of progressive, painless difficulty in opening the mouth. The purpose of this study is to evaluate the outcomes of five patients with CPH treated by coronoidectomy, relative to post surgery jaw function.Methods: Five patients with CPH were included in this study. The diagnosis of CPH was confirmed by radiographic and clinical examination of the mandible. All five patients underwent bilateral intraoral coronoidectomy under general anesthesia. The mean maximum interincisal mouth opening for the patients was determined by measurements taken pre-surgery, intraoperative, and at longest follow-up. All five patients underwent postsurgical physical therapy directed towards jaw function.Results: All the patients with limited mouth openings presented with a preoperative maximum interincisal mouth opening of 12.4 mm (range 9-20.3 mm), which was increased to 37 mm (range 22-52 mm) in the operating room after bilateral intraoral coronoidectomy and 42 mm (range 32-52 mm) during the late follow-up.Conclusions: Patients with limited jaw function related to bilateral CPH can benefit by undergoing bilateral coronoidectomies and physiotherapy. [ABSTRACT FROM AUTHOR]

Open mouth jaw locking in dogs and cats is characterized by an inability to close the mouth that usually results from fixed mandibular coronoid process displacement lateral to the ipsilateral zygomatic arch and abnormal contact pressure between these two structures. Other causes of an open mouth persentation include temporomandibular luxation or dysplasia and trigeminal neuropathy. While historic and physical findings can be suggestive of likely causes, imaging, most commonly radiography, is often required to confirm the diagnosis, and computed tomography may be used as an adjunctive or the sole imaging modality. Manual reduction is the first-line treatment method in open mouth jaw locking secondary to coronoid processzygomatic arch interlocking and temporomandibular dislocation. An understanding of the anatomy and function of the temporomandibular joint is essential in making a diagnosis and in the management of the different conditions. This report describes the clinical presentation, imaging diagnosis and management of a case of feline open mouth jaw locking and temporomandibular joint luxation and subluxation. An intra-oral approach to manual reduction is described in the report. [ABSTRACT FROM AUTHOR]

The morphological and morphometrical study of mandibles of hyena was carried out at Sakkarbaug Zoo, Junagadh (Gujarat). The average weight, length and width of mandible was 0.221 kg, 14.25 cm and 1.84 cm, respectively. The mandible was formed by two symmetrical halves fused rostrally by symphysis. The average length of symphysis mandibularis was 4.75 cm. The alveolar border presented six alveoli for lower incisors, two large deep alveoli for canine teeth, three alveoli for premolars and one for molar teeth. The diastemal mandibular length was 2.69 cm. The mental foramen was one. The mandibular height up to condylar and coronoid processes were 9.16 and 6.74 cm, respectively. The distance of mandibular foramen from posterior border was 3.22 cm. The angular process was placed at caudal border of horizontal ramus and found pointed and laterally curved. The average length of angular process was 1.23 cm. [ABSTRACT FROM AUTHOR]

The condylar articular cartilage is a mandibular growth site. As a result, developmental abnormalities at this location manifest as altered growth on the affected side of the condyle, mandibular ramus, mandibular body, and alveolar process. There are many causes of the various growth disturbances and abnormalities of the mandibular condyle and related structures. The authors report an interesting case of unilateral severe condylar hypoplasia secondary to chronic ear infection in childhood. Coronoid hyperplasia was also present on the ipsilateral side. [ABSTRACT FROM AUTHOR]

Introduction: The coronoid is a crucial element for elbow stability. In case of posttraumatic instability or reduced range of motion, a complex reconstruction might be necessary.Case: We present the case of a polytraumatized patient with complex upper extremity injury and initial poor outcome. Subluxation after initial surgery was treated by sublime tubercle reconstruction with a corticocancellous iliac crest graft. Due to massive ossification, the elbow remained stiff and the paraplegic patient was unable to use a manually propelled wheelchair. After arthrolysis, the unstable elbow was treated with an osteocartilaginous graft from the navicular of the foot as well as ulnar and radial collateral ligamentoplasties. At the time of follow-up, the patient had a stable joint and was able to independently perform activities of daily living.Conclusion: An autologous navicular graft seems to be an excellent option for our paraplegic patient as the shape matches the sublime tubercle of the ulna. [ABSTRACT FROM AUTHOR]

We treated one patient with a mid-diaphyseal radius fracture and concomitant anteromedial facet fracture of the coronoid. The ulnohumeral joint was severely unstable by complete ligament detachment and interosseous membrane rupture. Despite this gross instability, the radiocapitellar was congruent and stable. The possible mechanism of radiocapitellar stability is discussed and the concept of concavity-compression stability across the radiocapitellar joint is emphasized. [ABSTRACT FROM AUTHOR]

Purpose: Jacob's disease (JD) is an uncommon disorder that presents as pseudojoint formation between the enlarged mandibular coronoid process and the zygoma, resulting in mouth opening limitation (MOL). Intraosseous lipoma (IOL) usually presents in the long bone, but it is very rare in the mandible. The authors present a rare case of JD and coexisting IOL in the same anatomical area and discuss diagnosis and surgical intervention.Clinical Presentation and Intervention: The patient was a 39-year-old Korean female with MOL. Magnetic resonance imaging showed a large lobulated mass with fat-specific signal intensity. A combined extraoral and intraoral approach was used to resect the large mass. Histopathologic examination revealed a degenerated lipomatous tumor replacing the marrow cavity, with cartilaginous cap formation on the articular surface.Conclusion: Postoperatively, the patient showed uneventful healing and resolution of MOL. [ABSTRACT FROM AUTHOR]

Mandibular coronoid process hyperplasia is a rare developmental condition. It commonly presents with progressive restriction of mouth opening, due to the impingement of the enlarged and elongated coronoid process on the distal aspect of the zygomatic arch during mandibular movement. It may present unilaterally or bilaterally. Surgical intervention to improve opening is advocated in cases with significant functional impairment, followed by post-operative physiotherapy. A case of bilateral coronoid process hyperplasia in a 28-year-old man treated with bilateral coronoidectomy, with subsequent post-operative relapse in degree of opening successfully treated via manipulation under intravenous sedation is presented. [ABSTRACT FROM AUTHOR]

Background and Purpose: Segmental, depressed fractures of the posterolateral maxillary sinus may occur as a result of trauma to the masticator space, previously described in association with mandibular fractures. The authors hypothesize that the fracture is due to a transient increase in pressure in the masticator space (blow out) and therefore should be seen in association with other regional fractures.Materials and Methods: Injuries of the masticator space were retrospectively identified by searching the imaging database from January 2014 to November 2014 for keywords that would identify regional trauma. The images were reviewed for segmental depressed fractures in the posterolateral aspect of the maxillary sinus accompanied by herniation of a variable amount of masticator space fat and/or muscle into the adjacent sinus. Three neuroradiologists reviewed the images and agreed by consensus on the presence or absence of a masticator space blowout fracture.Results: Forty-three zygomaticomaxillary complex (ZMC) fractures, 89 mandibular fractures, and 49 isolated zygomatic arch fractures were identified. While all of the ZMC fractures had a maxillary component, 3 of 43 (7.0 %) additional fractures met our fracture definition. Five of 89 (5.6 %) of the mandibular fractures and 6 of 49 (12.2 %) zygomatic arch fractures had an associated posterolateral maxillary fracture.Conclusions: Segmental depressed fracture of the posterolateral maxillary sinus is relatively common, occurring in conjunction with other regional injuries. The authors hypothesize that it is due to a transient increase in pressure in the masticator space and is a separate entity from other fractures of the region that may occur concurrently. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the association between coronoid process hyperplasia and temporomandibular joint (TMJ) ankylosis and to analyze the pathological mechanism and clinical significance of coronoid process hyperplasia. Forty-four patients treated for TMJ ankylosis between January 2007 and December 2014 were studied retrospectively; 176 patients with normal TMJs served as controls. The original DICOM data were used to reconstruct the jaw, and a three-dimensional cephalometric analysis (SimPlant Pro software version 11.04) was performed to assess the association between the severity of TMJ ankylosis and the height of the coronoid process. The height of the coronoid process was 20.41 ± 5.00 mm in the case group and 14.86 ± 2.67 mm in the control group; there was a significant difference between the two groups ( P < 0.001). Long-standing TMJ ankylosis contributes to coronoid process hyperplasia. Therefore, attention should be drawn to the coronoid process in patients with TMJ ankylosis. A coronoidectomy together with arthroplasty is recommended in patients with TMJ ankylosis. [ABSTRACT FROM AUTHOR]

Introduction: Coronoid process is a bony projection from the ramus of the mandible. Its anterior border is convex and continuous with the anterior border of ramus of mandible. The variations in the shapes of coronoid process are of three, namely triangular, hook, and rounded. Different morphological variations of the coronoid process have been documented in literature as indispensable aids in anthropological and forensic studies. Materials and Methods: In the present study, a total of 50 dry human mandibles of unknown sex and without any gross breakage were collected and subjected for morphometrical analysis and evaluated. Shapes of the coronoid process on both sides of the mandible (individual = 50; both sides = 100) were analyzed. The different shapes of coronoid process were compared for difference on either side. The intercoronoid distance was also measured. The various shapes of the coronoid process were interpreted as given by Shakya et al., as triangular, round, beak/hook, and flat shapes. Results: The change in the shapes of the coronoid process on both sides of the mandible was observed. An overall mean for these parameters was calculated using the data obtained. Values were found for the right and left acetabulum. The raw data obtained were statistically analyzed. Range, mean, standard deviation, and standard error of mean were determined for each parameter. All values were compared with series of other workers to draw the conclusions. Conclusion: In this regard, the present study was undertaken to depict various morphological disparities of the coronoid process in our ethnic group so as to aid in personal identification. Knowledge of the morphological shapes of the coronoid process is useful for the maxillofacial surgeon. The coronoid process can be easily harvested as a donor bone. It also helps in determining buccal vestibule during denture fabrication. [ABSTRACT FROM AUTHOR]

Abstract We describe a new approach to the planning of treatment and subsequent operation on a patient with syngnathia and severe mandibular retrognathism. To facilitate a large mandibular advancement we applied alloplastic temporomandibular joint (TMJ) prostheses to the coronoid processes after anticlockwise rotation of the mandible. To the best of our knowledge this is the first documented case of its kind. [ABSTRACT FROM AUTHOR]

The cerato-mandibular (c-md) ligament, joining the hyoid bar to the coronoid process of the angular, allows Pomacentridae to slam their mouth shut in a few milliseconds. Previous works have revealed that such a mechanism is used to feed, but some variability in biting patterns has been observed between two damselfish species. The pelagic feeder Amphiprion clarkii performs two different kinematic patterns to bite fixed prey, one that does not depend on the c-md ligament ( biting-1 ) and one that does ( biting-2 ). The benthic feeder Stegastes rectifraenum only performs biting-2 . The present study aims to shed light on the occurrence of biting-2 in the feeding behaviour of Pomacentridae. To test our hypothesis that biting-2 would be the only biting pattern for benthic feeders, we compared biting behaviours among four species: one pelagic feeder, A. clarkii , and three benthic feeders, Neoglyphidodon nigroris , Stegastes leucostictus and S. rectifraenum . Our results showed that the four species were able to perform biting-2 , but they do not support that the use of this pattern is related to trophic habits. Contrary to S. rectifraenum , the two other benthic feeders randomly used biting-1 and biting-2 patterns, similar to A. clarkii . Two hypotheses are discussed for explaining this variability within Pomacentridae. Finally, it has been recently shown that some damselfishes do not possess the c-md ligament. We therefore included two species lacking the c-md ligament ( Chromis chromis and Abudefduf troschelii ) in our study and we demonstrate our expectation that they are unable to perform biting-2 . [ABSTRACT FROM AUTHOR]

Objectives: To measure the lengths of the force and resistance arms, in order to calculate the mechanical advantage and muscular work of the human temporalis muscle (TM) in brachyfacial (BR) and dolichofacial (DO) subjects.Setting and Sample Population: Mandibles from 49 subjects of both genders (BR n = 9; DO n = 40) from the collection of the Laboratory of Human Anatomy at Universidade de Santa Cruz do Sul, Rio Grande do Sul, Brazil, were analyzed.Material and Methods: The distance between the condylar process and the coronoid process (insertion site of the TM) represented the length of the force arm (LFA ) of the TM. The distance between the condylar process and the mental protuberance represented the length of the resistance arm (LRA ). Thus, the mechanical advantage of the TM was obtained using the following ratio: LFA /LRA , while the muscular work (LRA /LFA ) of the TM was obtained using the inverse of this ratio.Results: When compared with the DO, the parameters of the BR are significantly greater, as shown by the LFA (6.0%) and mechanical advantage (8.2%; p = 0.0078). By contrast, our results show that in the DO, the LRA was 2.4% longer and the muscular work was 10.4% greater (p = 0.0087).Conclusion: The mechanical advantage of the TM in BR subjects is significantly greater than in DO subjects. Moreover, this greater mechanical advantage may explain, at least in part, the higher incidence of temporomandibular dysfunctions in BR subjects. [ABSTRACT FROM AUTHOR]

Fragmentation of the medial coronoid process (FCP) is an uncommon cause of thoracic limb lameness in toy and small breed dogs. Arthroscopic findings and treatment remains poorly described. The objective of this study was to describe the arthroscopic findings and short-term outcome following arthroscopic treatment in toy and small breed dogs with FCP. Medical records were retrospectively reviewed. Arthroscopic findings were available from 13 elbows (12 dogs). Outcome data ≤4 wk postoperatively were available for nine elbows. Owner satisfaction scores were available for 10 elbows. Common preoperative findings included lameness, elbow pain, and imaging abnormalities consistent with FCP. Displaced FCP was the most common FCP lesion identified. Cartilage lesions at the medial coronoid process were identified in 92.3% of elbows (n=12), with a median Outerbridge score of 4 (range 1-5). Concurrent cartilage lesions of the medial humeral condyle were identified in 76.9% of elbows (n = 10). Seven of nine elbows had full or acceptable function postoperatively. Median owner outcome satisfaction was 91% (range 10-100). FCP should be considered a cause of thoracic limb lameness in toy and small breed dogs. Arthroscopy can be safely and effectively used to diagnose and treat FCP in these breeds. [ABSTRACT FROM AUTHOR]

Ewing sarcoma (ES) is a rare, primary malignancy of the bone that occurs mainly in childhood and early adolescence. ES usually occurs in long bones of the axial skeleton. Although uncommon in the jaws, ES at this site is most likely to occur in the posterior mandible. The outcome for patients with localised disease has improved over the decades, due to better combination chemotherapies and better methods of local control. We present the clinicopathologic features and management of a case of ES that developed in the left coronoid process of the mandible of a 31-year-old male. Chemotherapy and, later, a segmental mandibulectomy were used to achieve local control. A fibula-free flap repair was performed with good aesthetic results. This case elucidates the importance of the interdisciplinary approach required for the evaluation and treatment of this aggressive neoplasm. [ABSTRACT FROM AUTHOR]

Background: The combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture is known as "terrible triad" injury of the elbow. This injury is one of the most challenging injuries of the musculoskeletal system and almost always causes instability of the elbow. The use of an adjuvant hinged external fixator in such injuries is still debated. Case Presentation: In this case report we present a case of radial nerve palsy after setting up an adjuvant hinged external fixator in a complex fracture-dislocation of the elbow. The patient was a 39-year-old white man. A revision of his radial nerve was undertaken at 7 weeks. A radial nerve injury at two levels facing the humeral apex pins was found intraoperatively; the pins were carefully removed and partial nerve grafts done. The functional outcome at 18 months was excellent. Conclusion: This case report highlights that the use of an adjuvant hinged external fixator in complex fracture -dislocation of the elbow is technically demanding and not without risk. [ABSTRACT FROM AUTHOR]

Introduction: A large number of disorders affecting the masticatory system can cause mouthopening restrictions. Among them is Jacob's disease, characterized by restricted jaw movements and caused by pressure of the mandible coronoid process, which is longer than normal in size, on the posterior aspect of the zygomatic arch, together establishing new joint formation. Observation: We present a case report of a 29-year-old male patient presenting limited mouth opening. Inter-incisal maximum mouth opening was 5 mm. On panoramic radiograph an elongated coronoid process of the mandible was evident. Computed tomography (CT) scans showed the relationship between the exophytic mass and the inner surface of the zygomatic arch. An extra-oral coronoidectomy was performed. A mouth opening of 55 mm was achieved intra-operatively. The post-operative period was without complications. The histopathological diagnosis was osteochondroma. Discussion: The clinical, radiological and histopathological characteristics and surgical approach to Jacob's disease are discussed. Conclusion: In a patient with a limitation of mouth opening, and without any temporo-mandibular joint disease, an examination of the coronoid process is required to identify hypertrophy ofthe coronoid process and to diagnose Jacob's disease. [ABSTRACT FROM AUTHOR]

The aim of this non-randomised investigation was to assess the feasibility of using autogenous grafts (such as coronoid process and the resected ankylotic mass) in reconstruction of the condyle after gap arthroplasty for ankylosis of the temporomandibular joint (TMJ). Sixteen patients (23 joints) operated on between 2007 and 2009 were studied and postoperative measurements of maximum interincisal opening, bite force, range of movement, and infection were recorded. After a mean (SD) follow up of 55 (2.25) months mouth opening improved from 3 (3.84) mm to 33 (1.66) mm in patients treated with coronoid graft, while in patients treated with an ankylotic mass after a mean (SD) follow up of 58 (1.58) months it increased from 4 (2.64) mm to 26 (8.04) mm. Bite force six months postoperatively ranged from 18.25 kg/cm 2 – 27.5 kg/cm 2 after reconstruction with the coronoid process and 18.5 kg/cm 2 – 23.25 kg/cm 2 after reconstruction with the ankylotic mass. One patient developed reankylosis postoperatively and another developed infection, in both of which the ankylotic mass had been used. Both were managed successfully. Both the ankylotic mass and the coronoid process gave satisfactory results and seem to be options for reconstruction. However, the coronoid process graft was better than residual ankylotic mass in terms of masticatory efficiency, bite force, and range of movement. [ABSTRACT FROM AUTHOR]

We identified three individuals of the Mediterranean water shrew (Neomys anomalus) in Estonia, expanding the known distribution range of the species to the north by 500 km from the most northern location in Lithuania and over 700 km from Poland. The identification of the species in Estonia, the most northern known locality, was based on the position of mental foramen, height of coronoid process (>4.3 mm), and Libois index (<16.5). Individuals in the northern populations of N. anomalus were smaller than those from southern populations. The most reduced features (by about 10%) are the length of the maxillary and mandibular tooth rows, skull breadth, and height of mandibula. The range expansions require reconsidering known diagnostic characters of the species in comparison with the sympatric N. fodiens as well as the cut-offs for their measurements and, possibly, highlight the need to search for new diagnostic criteria. [ABSTRACT FROM AUTHOR]

Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature but the ectopic eruption into the non dentate region is rare. Diverse anatomical locations such as nasal cavity, nasal septum, mandibular condyle, coronoid process, the palate and the maxillary sinus can infrequently be non dentate sites of ectopic eruptions of teeth. While conducting an anthropometric study on 100 skulls an incidental and interesting case of ectopic maxillary third molar tooth was found. The tooth was partially erupted with the unerupted part lying impacted in the posterior wall of maxilla. The case is reported and discussed for its significant clinical implications. [ABSTRACT FROM AUTHOR]

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We describe a rare case of osteochondroma of the coronoid process of mandible accompanied by severe trismus in a 14-year-old Japanese boy. The patient had initially been diagnosed as having internal derangement of the temporomandibular joint (TMJ), and conservative treatment had failed to improve the symptoms. Despite extremely limited TMJ movement, panoramic radiography revealed no abnormality, but magnetic resonance imaging suggested internal derangement of the left TMJ. Five months later, the trismus worsened and computed tomography revealed a bone-like mass confluent with the coronoid process, which was finally diagnosed as osteochondroma. The patient then underwent intra-oral coronoidectomy. [ABSTRACT FROM AUTHOR]

Bilateral mylohyoid bridging, hyperplasia of the coronoid process and bifid condylar process were detected in a human mandible. It is of great interest that such rare morphological anomalies can occur in the same mandible. Since sound understanding of the anatomical variations of the mandible, in conjunction with a careful pre-operative review of radiographs, are essential in the safe and complete performance of surgical and prosthetic rehabilitation, the authors of the present report believe that this case may add to the existing literature. [ABSTRACT FROM AUTHOR]

The mandible is the most common fractured bone of the facial skeleton. The aim of the study is to make an analysis mainly regarding the two options of treatment, the surgical and non-surgical methods. The study included all 65 patients (mean age 32.08±15.024 years) who were treated for mandible fractures within Timisoara's Department of Maxillofacial Surgery in 2013. Considering the current social and economical context we thought that a cost analysis of the two methods of treatment is useful. We took in consideration the days of hospitalization and the hospitalization cost. [ABSTRACT FROM AUTHOR]