Comparison of clinical efficacy of temporalis myofascial flap and dermal graft as interpositional material in treatment of temporomandibular joint ankylosis

Abstract

Temporomandibular joint (TMJ) ankylosis is a very distressing structural condition. Interpositional arthroplasty has become the acceptable standard for the primary surgical management of TMJ ankylosis. Up to now, diverse interpositional materials have been proposed in this regard, with especial advantages and limitations. The temporalis muscle and facial flap, as well as the dermal graft, are among the most popular ones. This study aimed to compare the short-term clinical consequences between these 2 interpositional materials in patients with operated TMJ ankylosis. MATERIALS AND METHODS: Twenty patients with TMJ ankylosis were randomized in 2 age- and sex-matched 10-patient groups and received either a temporalis muscle and facial flap or a dermal graft as the interpositional material. The maximal incisal opening (MIO) and the amount of lateral excursion (LE) were measured before and 3 months after surgery, and the mandibular deviation (MD) at the mouth opening 3 months after operation was compared between the 2 groups. RESULTS: Twenty patients were enrolled in the study. The presurgical MIO and LE were not significantly different between the 2 groups. Three months after the operation, evaluation of the patients did not reveal a significant difference considering the amount of the MIO, LE, or MD. The mentioned parameters were significantly improved 3 months after the operation in both groups. CONCLUSIONS: The interpositional arthroplasty in TMJ ankylosis patients using either a temporalis muscle and facial flap or a dermal graft would yield a comparable and almost satisfactory clinical outcome. © 2010 by Mutaz B. Habal, MD.