Prospective analysis of temporomandibular joint reconstruction in ankylosis with sternoclavicular graft and buccal fat pad lining.

Abstract

PURPOSE:

To evaluate the feasibility of sternoclavicular graft (SCG) as an adaptive center along with buccal fat pad (BFP) lining for temporomandibular joint (TMJ) reconstruction in TMJ ankylosis.

PATIENTS AND METHODS:

A prospective, preliminary, short-term study with only 6 months' follow-up was performed in 10 patients with TMJ ankylosis. All patients had complete osseous ankylosis, and the mean duration of ankylosis was 6.4 years (range, 3 to 13 years). Interpositional arthroplasty with SCG along with BFP lining was done in all cases. Postoperative clinical and radiographic follow-up was performed for 6 to 9 months.

RESULTS:

Maximum interincisal opening at 6 months' follow-up was 35.6 ± 4.97 mm (range, 31 to 45 mm). Similarly, protrusive movement at follow-up of 6 months was 2.7 ± 1.25 mm (range, 1.5 to 5.5 mm), whereas laterotrusive movement was 4.1 ± 1.98 mm (range, 1.5 to 7.0 mm) toward the affected side and 2.4 ± 0.99 mm (range, 1 to 4.0 mm) toward the normal side. After 3 months, 9 of 10 patients had no pain on function, and all the patients were relieved of pain at the end of 6 months. On radiographic follow-up at 9 months, there was noticeably significant adaptation and remodeling of SCG as observed on panoramic radiography and computed tomography scan. In all the patients there was some degree of mandibular deviation toward the operated side, although the occlusion was satisfactory and they were pleased with the outcome.

CONCLUSION:

On the basis of the findings of this study, we conclude that after release of TMJ ankylosis, reconstruction with SCG combined with interposition of BFP lining followed by vigorous physiotherapy is a successful strategy for the management of TMJ ankylosis with short-term follow-up of 6 months.

• Authors: Virendra Singh, Rahul Dhingra, Amrish Bhagol
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 70 Issue 4 Pg. 997-1006 (Apr 2012) ISSN: 1531-5053 [Electronic] United States
• PMID: 21764199 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Chewing Gum

Topics

• Adaptation, Physiological (physiology)
• Adipose Tissue (transplantation)
• Adolescent
• Adult
• Ankylosis (surgery)
• Arthroplasty (methods)
• Bone Remodeling (physiology)
• Bone Transplantation (methods)
• Chewing Gum
• Child
• Clavicle (surgery)
• Feasibility Studies
• Female
• Follow-Up Studies
• Hot Temperature
• Humans
• Male
• Massage
• Patient Satisfaction
• Prospective Studies
• Radiography, Panoramic
• Range of Motion, Articular (physiology)
• Plastic Surgery Procedures (methods)
• Temporomandibular Joint Disorders (surgery)
• Tissue and Organ Harvesting (methods)
• Tomography, X-Ray Computed
• Young Adult