Jaw Angle Ligaments

Q: Dr. Eppley, My question is in relation to the jaw angle ligaments near the insertion site of jaw angle implants. I saw below that there is a sphenomandibular ligament and a stylomandibular ligament at the back of mandible. I was wondering what happens here since they are directly in the area of insertion/fixation?

A: Only one of the ligaments to which your refer attaches in the region of the jaw angle, the stylomandibular ligament. The sphenomandibular ligament is located on the inner surface of the jaw angle high above the angle and not on the outer surface so it is completely out of the way and is not a factor in jaw angle implants surgery.

In normal jaw angle augmentation cases, the stylomandibular ligament may need to be  stripped off the bone to allow any vertical lengthening jaw angle implant to be properly placed. But in your case with a prior history of aw angle reduction those ligament attachments have already been released since the bony ja angle was removed.

Loss of the styhlomandibuar ligament attachment has no functional or aesthetic significance. It is disruption of the pterygomasseterinc sling that can can cause an unaesthetic relocation of the masseter muscle bulge when clenching or chewing.

Dr. Barry Eppley

Indianapolis, Indiana