Orofacial dystonia, Angle fracture, Reconstruction plate, Osteomyelitis
As the angle is a weak region in the continuity of mandible, so it is more prone to fracture. It has been proven time and again that coronoid fracture results from a strong sudden contraction of temporalis. Muscular forces influence the remodeling of bones. Orofacial dystonia is a centrally mediated disease in which there is an uncontrolled spasmodic contraction of facial and masticatory muscles. This continuous force applied over a long period of time has the potential to unfavorably remodel or weaken bone. A case is presented in which the dystonic action of facial musculature gradually resorbed the bone to such an extent that there was spontaneous fracture at the right angle of mandible as well as the contra lateral coronoid. Management of this fracture posed a challenge at every step eventually leading to resection of the ramus-condyle unit. No case has been reported so far in the literature where dystonic movements have resulted in fracture of the mandible.
Mohanty, S., & Gulati, U. (2013). Mandibular angle and coronoid process fracture secondary to orofacial dystonia: report of a case, International Journal of Orofacial Myology, 39 (1), 24-30.