TMJ diskectomy with abdominal fat graft vs. temporalis myofascial flap: a comparative study

Publication date: Available online 12 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Matt DeMerle, Olubukola O. Nafiu, Sharon Aronovich
PurposeOpen temporomandibular joint (TMJ) arthroplasty with diskectomy has been described as a primary surgical treatment, or secondary when minimally invasive procedures have failed. The aim of this study would be to compare TMJ diskectomy with fat graft vs TMJ diskectomy with temporalis graft based on pain score and maximal interincisal opening (MIO).Materials & MethodsWe performed a retrospective study of patients who underwent TMJ arthroplasty and diskectomy with abdominal fat graft or interpositional temporalis flap at University of Michigan between 1999 and 2014. The predictor variable was the type of surgical intervention and the outcome variables included pain score, maximal interincisal opening, and diet. Other outcome variables included medication use, presence of myofascial pain, and occlusal outcomes. Statistical analysis included means with standard deviations, a one-way ANOVA for continuous data and a Pearson's chi-squared test for categorical variables.ResultsThe study cohort included 50 patients, of which 30 underwent diskectomy with fat graft and 20 who underwent diskectomy with temporalis myofascial graft. The mean pain scores were shown to have a 78.3% decreased in the myofascial flap group and 52.8% decrease in the fat graft group. Changes in incisal opening showed a significant increase in the fat group, but only approached significance in the myofascial flap group.ConclusionPatients who underwent TMJ arthroplasty and diskectomy with temporalis myofascial flap showed a significantly greater improvement in pain scores and marginal improvement in MIO when compared to patients who had an abdominal fat graft.



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