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Bilateral Hyperplasia of the Coronoid Process in Pediatric Patients

What is the Gold Standard for Treatment?

Farronato, Marco, DDS, PD*; Lucchina, Alberta Greco, DDS; Mortellaro, Carmen, MD, DDS; Fama, Andrea, DDS*; Galbiati, Guido, DDS, PD*; Farronato, Giampietro, MD, DDS*; Maspero, Cinzia, MD, DDS*

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1058–1063
doi: 10.1097/SCS.0000000000004768
Clinical Studies

Objectives: The aim of this systematic review of the literature is to describe treatment options for bilateral coronoid process hyperplasia in pediatric patients, to describe etiologic and diagnostic correlations with the treatment, and to evaluate long-term follow-up treatment outcomes.

Methods: A systematic revision of the literature was performed in the Medline, PubMed, Cochrane library, and Embase database up to December 5, 2017. Predetermined Medical Subject Heading keywords were used: “bilateral” or “monolateral” and “coronoid” or “coronoid process” and “hyperplasia” and “temporomandibular joint” or “tmj” and “ankylosis” or “trismus” and “treatment.” Results were recorded following PRISMA guidelines.

Results: The systematic research produced 1459 results excluding duplicates. Two additional studies from “Grey literature” were also considered. After application of inclusion and exclusion criteria, 38 articles were selected for a qualitative synthesis. Data regarding sex and age of presentation were collected and summarized in a study flow diagram.

Conclusion: It is possible to conclude that early diagnosis is fundamental to restore stomatognathic multifunction. There is lack of longitudinal studies presenting long-term follow-up to determine treatment stability. Coronoidectomy might be considered gold standard treatment for this pathologic condition.

*Università Degli Studi di Milano

Università Degli Studi del Piemonte Orientale

Department of Medical Science, University of Eastern Piedmont, Novara, Italy.

Address correspondence and reprint requests to Marco Farronato, DDS, PD, Università degli studi di Milano, Via Francesco Sforza 28, Milano 20122, Italy; E-mail:

Received 2 May, 2018

Accepted 24 May, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.