Research Article

Variations in the shape of the coronoid process in the adult

human mandible
Sam Jebaraj1, Saravana Kumar2*

ABSTRACT

Objective: The aim of this study is to evaluate the variations in the shape of coronoid process in the adult human mandible.
Methods: The shape of the coronoid processes of both sides of 103 dry adult human mandibles, 67 males and 36 females
of Indian origin, was studied to classify the variations. Three types were evident: (1) Hook shaped, (2) triangular, and (3)
rounded. Results: Hook-shaped coronoid processes were found in 56 (27.4%) sides, triangular in 101 (49%), and rounded
in 49 (23.6%) sides. Hook-shaped coronoid processes were found bilaterally in 23, triangular in 42, and rounded in 17
mandibles. Of the remaining 21 mandibles, the appearances were different on both the sides. Conclusion: The incidence of
the rounded type was almost equal in male and female mandibles; in the triangular type, it was slightly more in the female
mandibles while the hook-shaped type was slightly more in the male mandibles.

KEY WORDS: Coronoid, Mandible, Osteology

INTRODUCTION shaped, (2) triangular, and (3) rounded [Table 1 and

The coronoid process of the mandible, as described
in textbooks, is a somewhat flat, triangular process
projecting upward and slightly forward. Its borders
and the medial surface give attachments to a muscle
called temporalis. For the reconstructive purposes, the
maxillofacial surgeons consider this coronoid process
as clinically significant one. This study was done to
evaluate the variations and their prevalence in dry
adult human mandibles.
MATERIALS AND METHODS
The study was conducted on 157 dry adult human
mandibles (314 sides), 100 males and 57 females of
Indian origin, to determine the variations in the shape
of the coronoid process.
OBSERVATIONS AND RESULTS
Shapes of Coronoid Processes
Depending on the shapes of the coronoid processes,
they were classified into three types: (1) Hook
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Figures  1-3]. The hook-shaped coronoid process
(type 1) had a tip which was pointing backward. This
was present in 56  (27.4%) sides. In 23 mandibles
(46 sides), it was present bilaterally, while in 10
mandibles (four right and six left), it was present
unilaterally. Of the four mandibles which had a hook-
like coronoid process on the right side, two were
associated with a triangular coronoid process on the
left side and two were associated with a rounded
coronoid process on the left side. Of the six mandibles
which had a hook-like coronoid process on the left
side, four were associated with a triangular coronoid
process on the right side and two were associated
with a rounded coronoid process on the right side.
The triangular coronoid process (type  2) with a tip
pointing straight upward was seen in 101 (49%) sides.
In 42 mandibles (84 sides), it was present bilaterally,
while in 17 mandibles (11 right and 6 left), it was
found unilaterally. Of the 11 mandibles, which had
a triangular coronoid process on the right side, four
were associated with a hook-shaped coronoid process
on the left side and seven were associated with a
rounded coronoid process on the left side. Of the six
mandibles which had a triangular coronoid process on
the left side, two were associated with a hook-shaped
coronoid process on the right side and four with a
rounded coronoid process on the right side. The type 3

Department of  Anatomy, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India, 2Department of
1

Anatomy, Faculty of Medicine, SEGi University, Petaling Jaya, Malaysia

*Corresponding author: Saravana Kumar, Faculty of Medicine, SEGi University, Petaling Jaya, Malaysia. Tel.: 9444888148.
E-mail: samjebaraj8@gmail.com

Received on: 15-08-2018; Revised on: 17-09-2018; Accepted on: 22-10-2018

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 Sam Jebaraj and Saravana Kumar
Table 1: Distribution of the coronoid process in adult human mandibles (206 sides)
Type Shape
1 Hook shaped (n=56, 27.4%)
2 Triangular (n=101, 49.0%)
3 Rounded (n=49, 23.6%)
Figure 1: Hook shaped
Figure 2: Triangular
Figure 3: Rounded
coronoid process had a rounded tip and was present
in 49  (23.6%) sides. In 17 mandibles (34 sides), the
rounded coronoid process was present bilaterally, and
in 15 mandibles (six right and nine left), it was present
640
Bilateral Unilateral right Unilateral left
46 4 6
84 11 6
34 6 9
unilaterally. Of the six mandibles which had a rounded
coronoid process on the right side, two were associated
with a hook-shaped coronoid process on the left side
and four were associated with a triangular coronoid
process on the left side. Of the nine mandibles which
had a rounded coronoid process on the left side, two
were associated with a hook-shaped coronoid process
on the right side and seven were associated with a
triangular coronoid process on the right side.
Distribution of various types in male and female
mandibles
The distribution and incidence of the various types
of coronoid process were noted in male and female
mandibles [Table 2]. Of the 134 sides of mandibles
belonging to males, the hook-shaped type was found
in 41  (30%), triangular in 61  (46.5%), and rounded
in 31  (23.5%). Of the 114 sides of the mandibles
of females, the hook-shaped type was found in
15 (22.8%), triangular in 40 (53.5%), and rounded in
17 (23.6%).
DISCUSSION
The coronoid process, which has been defined as
one of the bony process of the ramus of mandible
where coronoid means hooked projection of bone.
Field et al., 1947.[1] Williams et al. (1995) described
the coronoid process as a flat triangular process.
Coronoid processes that are triangular in shape have
been illustrated by Hamilton,[2] Romanes,[3] Snell,[4]
and Basmajian and Slonecker.[5] Schafer and Thane[6]
described the coronoid process as beak shaped. In
this study, in 79.6% mandibles, the type of coronoid
process was the same bilaterally and only in 20.4%
mandibles did the presentation differ between sides.
The triangular and rounded types were the most
and the least prevalent in males (46.5% and 23.5%,
respectively), while in females, the triangular-  and
hook-shaped types were the most and the least
prevalent (53.5% and 22.8%, respectively).
The knowledge about the morphological shapes of
the coronoid process is useful for the maxillofacial
surgeon. The coronoid process is considered to be
one of the best donor graft sites for reconstruction of
orbital floor deformities, Clauser et al.[7] Mintz et al.[8]
reported the use of a temporalis myofascial flap both
as a single and as composite flap with cranial bone,
coronoid process, or skin island in all aspects of
reconstructive craniomaxillofacial surgery including
Drug Invention Today | Vol 11 • Issue 3 • 2019
 Sam Jebaraj and Saravana Kumar

Table 2: Distribution and incidence (in parentheses) of the coronoid process in males and females, bilateral or
unilateral (206 sides)
Type hook shaped Male (134 sides) Female (72 sides)
Bilateral Unilateral Bilateral Unilateral
33 8 13 2
(n=56) 24 6 19.3 3.5
Triangular shaped 51 10 33 7
(n=101) 39 7.5 43.9 9.6
Rounded shaped 23 9 11 6
(n=49) 18 5.5 14 9.6
Total 107 27 57 15
(n=206) 81 19 77.2 22.8

trauma, deformities, tumors, temporomandibular joint
ankylosis, and facial paralysis.
REFERENCES
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derivation. 1st ed. Cambridge: W Heffer and Sons Ltd.; 1947. p. 34.
2. Hamilton WJ. Textbook of Human Anatomy: Locomoter
System. 2nd ed. London: Macmillan; 1976. p. 80.
3. Romanes GJ. Cunningham’s manual of practical anatomy: The
Head and Neck. 15th ed., Vol. 3. Singapore: Oxford University
Press; 1986. p. 12.
4. Snell RS. Clinical Anatomy for Medical Students: The Head
and Neck. 3rd  ed. Boston: Little Brown and Company Inc.;
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5. Basmajian JV, Slonecker CE. Grant’s method of anatomy. In:
Side of Skull, Temporal and Infratemporal Regions. 11th  ed.
Baltimore, London: Williams and Wilkins; 1989. p. 516.
6. Schafer EA, Thane GD. Quain’s Elements of Anatomy: The
Bones of the Head. 10th  ed. London: Longmans, Green and
Co.; 1890. p. 60.
7. Clauser L, Curioni C, Spanio S. The use of the temporalis muscle
flap in facial and craniofacial reconstructive surgery. A review
of 182 cases. J Craniomaxillofac Surg 1995;23:203-14.
8. Mintz SM, Ettinger A, Schmakel T, Gleason MJ. Contralateral
coronoid process bone grafts for orbital floor reconstruction:
An anatomic and clinical study. J  Oral Maxillofac Surg
1998;56:1140-4.
Source of support: Nil; Conflict of interest: None Declared

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