Limited painful mouth opening.

A 45-year-old woman was referred with a complaint of imited mouth opening. The restriction had progressively ncreased after the removal of the right lower third molar 2 onths earlier. After tooth removal, the treatment for trisus consisted of analgesic, muscle relaxants, and mechantherapy. Past medical history revealed a left nephrectomy 1 years ago and the loss of 15 kg during the past 4 months. here were no known drug allergies. On extraoral examination, a slight asymmetry was seen n the left side of the face. The tenderness on the body of he masticatory muscles was recorded on palpation. The arotid glands were nontender and there were no masses. hen the patient was referred to our clinic, maximal mouth pening was to 14 mm with right and left lateral excursions f 7 and 3 mm, respectively. There was no temporomanibular joint tenderness, but a deviation was noted with outh opening. There was a submandibular lymphadenopthy. No sensory disturbance was noted. On intraoral examination, oral hygiene was poor and she ad periodontal problems. A mass was noted in the soft issues posterior and lateral to the right maxillary tuberosity nd retromolar region. Palatinal mucosa was inflamed and ragile on the right upper third molar, and the tooth was obile (Fig 1). Panoramic radiography showed that there was no bone rregularity in the extraction socket of the right lower third