Fabrication of a unilateral oral commissure retractor.

The fabrication of a unilateral device to treat microstomia after trauma is presented. Maximum opening was recorded before treatment. A dual arch impression that captured the dentition and commissure on the affected side was made with vinyl polysiloxane (VPS) impression material. A 1 mm vacuum formed template (VFT) was fabricated over the maxillary dentition, and a 2 mm VFT was fabricated around the commissure. A 0.9 mm (0.036") stainless steel wire was attached with acrylic resin to both templates in order to apply a constant force to the commissure. The use of a helix in the wire allowed for flexibility and adjustment of the retractor. The patient was instructed to wear the retractor for 6 hours per day, and, during a 10-week period, the maximum opening increased from 30 mm to 45 mm.