Volumetric Assessment of Temporalis Myofascial Flap, Buccal Fat Pad and Abdominal Dermal Fat Graft as Interpositional Materials in TMJ Ankylosis

Objective The purpose of this study was to conduct a clinic-radiographic quantitative evaluation of three interpositional materials, Temporalis myofascial flap (TMFF), Buccal fat pad (BFP) and Abdominal dermal fat graft (ADFG) in patients undergoing TMJ ankylosis (TMJA) release surgery. Materials and Methods 30 joints in 18 patients of TMJA were randomly assigned to three different interpositional material groups for clinical and radiological evaluation. Maximum mouth opening (MMO) and volumetric assessment of the graft using CT scan were recorded and followed up for one year. Results No statistically significant difference was noted in MMO between the three interpositional materials after 1 year (p >.05). However, statistically significant difference was noted in the volume of the graft between the three. Average graft volume at 1week in TMFF was 368.15 ± 39.57mm3 and at 1 year was 250.61 ± 37.72mm3; in BFP, at 1 week was 287.69 ± 20.37 mm3 and at 1 year was 267.11 ± 19.24 mm3; in ADFG, at 1 week was 284.18 ± 30.28 mm3and at 1 year was 280.7 ± 14.28mm3. ADFG showed the least volume reduction and TMFF showed the most. Minimal complications in terms of transient facial palsy and local infection were noted and treated conservatively. Conclusion At present the only study in the literature radiologically quantitatively assessing and comparing three interpositional grafts, ADFG is highly satisfactory; thereby may be hailed as arguably the best interpositional material in TMJA surgery.