Limited jaw opening

Abstract

A 21-year-old man was referred by his general dentist to the Oral and Maxilliofacial Surgery Clinic, College of Dental Medicine, Columbia University, New York City, for extraction of four asymptomatic unerupted third molars. The patient’s medical history indicated that he was in excellent health and had no history of pericoronal infections or head and neck trauma. Previous dental treatment included orthodontic braces and exposure of an impacted canine at age 13 years. Before the planned extractions, the clinician (D.R.) ordered a panoramic radiograph, which showed four impacted third molars (Figure 1). He did not observe any other abnormalities. No facial swelling or asymmetry was evident extraorally. The patient had no lymphadenopathy. Most striking was the presence of a markedly restricted jaw opening, which blocked access for the planned extractions (Figure 2). On questioning about the duration of the limited opening, the patient stated that he was unaware of any problem.