Comparison of temporomandibular joint reconstruction with free coronoid process graft and costochondral graft in the treatment of temporomandibular joint ankylosis

Abstract

Abstract: PURPOSE : To compare the effect of free coronoid process graft (CPG) and costochondral graft (CCG) in the treatment of temporomandibular joint ankylosis (TMJA). METHODS : Ten TMJA patients (15 joints) treated with CPG or CCG in our department from 2011 to 2014 were included in this study. All patients were followed up for more than 6 months after operation. Post operative CT scan data within 1 week after operation and during follow up were imported into the Proplan CMF 1.4 software (Materialize, Belgium) for 3 dimensional reconstruction and measurement. Bone absorption was measured and compared between the 2 METHODS using paired t test with SPSS 19.0 software package. Maximum mouth opening (MMO) and occlusion were also evaluated and compared before and after operation. RESULTS : In CPG group, the average follow-up duration was 16.8 months (ranged from 6-22 months). The average bone absorption was 5.41 mm (21.9% of the initial height). Tip of the grafted bone was reformed to be round. The average MMO was 31.6mm, which had significant difference between the preoperative values (P<0.05). Four of 5 patients developed open bite, one patient had TMJA recurrence. In CCG group, the average follow-up duration was 14.4 months (ranged from 6~30 months). The average bone absorption was 2.44 mm (6.2% of the initial height). The average MMO was 33.6 mm, which had a significant difference between the preoperative values (P<0.05). One of 5 patients developed open bite, the other 4 patients had stable occlusion. No patient had recurrence. CONCLUSIONS : In the treatment of TMJA, bony absorption rate in CPG patients was higher than that in CCG patients, which was easy to cause occlusion changes.

Key words: Temporomandibular joint ankylosis, Free coronoid process graft, Costochondral graft, Joint reconstruction

CLC Number:

R782.6

HUANG Dong, HE Dong-mei, YANG Chi, LU Chuan, BAI Guo. Comparison of temporomandibular joint reconstruction with free coronoid process graft and costochondral graft in the treatment of temporomandibular joint ankylosis[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(1): 33-38.

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