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. 2020 Mar;13(1):53-58.
doi: 10.1177/1943387520903876. Epub 2020 Apr 2.

A Clinical and Radiological Investigation of the Use of Dermal Fat Graft as an Interpositional Material in Temporomandibular Joint Ankylosis Surgery

Sajjad Abdur Rahman  1 , Tabishur Rahman  1 , Ghulam Sarwar Hashmi  1 , Syed Saeed Ahmed  1 , Mohammad Kalim Ansari  1 , Abdus Sami  1
Affiliations

A Clinical and Radiological Investigation of the Use of Dermal Fat Graft as an Interpositional Material in Temporomandibular Joint Ankylosis Surgery

Sajjad Abdur Rahman et al. Craniomaxillofac Trauma Reconstr. 2020 Mar.

Abstract

Management of temporomandibular joint (TMJ) ankylosis is mainly through surgical intervention. Interpositional materials are a necessity when it comes to prevention of TMJ re-ankylosis after arthroplasty. Early aggressive postoperative physiotherapy is essential for the prevention or treatment of TMJ hypomobility or ankyloses. Recently, it has been shown that abdominal dermis fat helps promote smooth, pain-free joint function and it is stable after interposition and less prone to fragmentation. The purpose of this study was to assess that whether dermal fat is a good choice of interpositional material when it comes to decreased pain perception during aggressive physiotherapy after release of ankyloses thus ensuring good compliance by the patient. We also assessed the fate of the graft material on computed tomography to evaluate any volume changes if occurred after interposition.

Keywords: ankylosis; dermal fat; reconstruction; temporomandibular joint; trauma.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
3-D CT image of a patient demonstrating TMJ ankylosis of right side. CT indicates computed tomography; TMJ, temporomandibular joint.
Figure 2.
Figure 2.
Maximum interincisal opening of a patient preoperatively.
Figure 3.
Figure 3.
Harvested dermal fat graft folded and sutured to conform to the superior and inferior surfaces of the gap created after removal of ankylotic mass.
Figure 4.
Figure 4.
Dermal fat graft in situ.
Figure 5.
Figure 5.
Maximum interincisal opening of the patient 6 months after the surgery.
Figure 6.
Figure 6.
Graph demonstrating number of patients experiencing pain at different time intervals with corresponding VAS scores. VAS indicates visual analogue scale.
Figure 7.
Figure 7.
Graph demonstrating 95% confidence interval in relation to mouth opening measurements.
Figure 8.
Figure 8.
Graph demonstrating 95% confidence interval in relation to lateral jaw movement measurements.
Figure 9.
Figure 9.
Coronal section of CT image obtained 6 months after surgery. CT indicates computed tomography.
See this image and copyright information in PMC

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