Costochodral graft with abdominal fat as Interpositinal graft versus costochodral graft alone for reconstruction of temporomandibular joint in bilateral ankylosis in adults: randomized controlled clinical trial

Abstract

Aim: The aim of this study was to evaluate the improvement of function and reduction of recurrence rate in patients with bilateral temporomandibular joint ankylosis treated with costochondral graft and interpositional fat compared to costochondral graft alone. Materials and Methods: This was a randomized controlled trial conducted on 10 adult patients with bilateral TMJ ankylosis. In control group, TMJ reconstruction was performed with costochondral graft after gap arthroplasty. While in the intervention group, the same procedure was performed with the addition of autogenous abdominal fat graft as interposition material. All patients were followed up for at least 6 months. The primary outcome was the percentage of patients with reankylosis in each group. The secondary outcome was the change in maximal incisal opening (MIO) after 6 months. Results: Both groups showed no recurrence. Intervention group showed lower change in the MIO (1.8 ± 0.84 mm) compared to the control group (2.4 ± 0.89 mm). Conclusions: Interpositional abdominal fat with costochondral graft TMJ reconstruction for management of bilateral temporomandibular joint ankylosis was found to be beneficial with promising results regarding maintained gained range of mandibular function, with relapse avoidance. However with no evidence of recurrence in any of our cases and the non significant difference in MIO, its superiority over costochondral graft TMJ reconstruction has not been proved yet.