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      Shifting the Spotlight From the Mandibular Condyle to the Coronoid Process: A Report of a Unique Case of Trifid Mandibular Coronoid Process

      case-report
      1 , , 2 , 1
      ,
      Cureus
      Cureus
      cone beam computed tomography, incidental, volume rendering, mandible, coronoid, trifid

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          Abstract

          The trifid mandibular coronoid process is an uncommon finding characterized by three projections arising from the mandibular ramus instead of a single triangular coronoid process. Previous authors reported cases of the bifid coronoid process. The authors referred to them as the bifid/second/double coronoid process. This article aims to report a unique case of a trifid coronoid process incidentally detected during radiographic evaluation for implant planning. This article also emphasizes the effectiveness of cone beam computed tomography (CBCT) volume rendering as a valuable tool in demonstrating morphological variations such as the trifid coronoid process. In addition, we discussed possible etiologies for the trifid coronoid process. To the best of our knowledge, this is the first case of the trifid coronoid process.

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          The human masseter muscle revisited: First description of its coronoid part

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            Jacob's disease secondary to coronoid process osteochondroma. A case report.

            The formation of a new joint between a pathologically elongated coronoid process and the body of the malar homolateral bone is known as Jacob's disease. Coronoid process hyperplasia was first described in 1853 by Von Langenbeck, and it was not until 1899 when Oscar Jacob described the disease that it was named after him. Jacobs's disease is an uncommon entity with only a few documented cases in the literature. The condition first manifests with progressive limitation of mouth opening and facial asymmetry. Pain is uncommon and it mainly affects young patients. Different factors have been postulated as possible causes, including temporal muscle hyperactivity, previous trauma, chronic disc displacement of the ipsilateral temporomandibular joint, endocrine stimuli, and genetic alterations. Definitive diagnosis is by histopathology and it is necessary to confirm bone hyperplasia, the presence of cartilage and synovial capsule forming the new joint between the malar bone and the coronoid process. We report a 52-year-old woman patient with a history of childhood trauma in the right preauricular region. She came to our department with a 2-year history of progressive limitation of mouth opening. Computed tomography (CT) revealed a right coronoid process elongation, in contact with the homolateral malar bone, causing it to deform. Surgery with general anesthesia was performed using an intraoral vestibular approach. Histopathology confirmed the diagnoses of Jacob's disease.
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              Three Cases of Elongated Mandibular Coronoid Process with Different Presentations

              Abnormal elongation of the mandibular coronoid process is rare and its etiology is not yet elucidated. The aim of this report is to demonstrate and discuss the relationship between elongated mandibular coronoid process and limitation of mouth opening with cone beam computed tomography. Although the clinical characteristic of elongation of the coronoid process is mandibular limitation, in this report, one case had problem with mouth opening. Axial scans revealed that the distance between the coronoid process and the inner face of the frontal part of the zygomatic bone may cause limitation in mouth opening. In conclusion, instead of the length, the distance between the coronoid process and the inner face of the frontal part of the zygomatic bone may be the actual reason for limitation of mouth opening. This may prevent misdiagnosis.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                14 April 2023
                April 2023
                : 15
                : 4
                : e37593
                Affiliations
                [1 ] Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
                [2 ] Oral and Maxillofacial Radiology, Virginia Commonwealth University School of Dentistry, Richmond, USA
                Author notes
                Article
                10.7759/cureus.37593
                10184719
                c553e1a1-c2bd-482d-8ff4-8aae70287e86
                Copyright © 2023, Nagpal et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 6 April 2023
                Categories
                Radiology
                Anatomy
                Dentistry

                cone beam computed tomography,incidental,volume rendering,mandible,coronoid,trifid

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