Transport distraction osteogenesis compared with autogenous grafts for ramus-condyle unit reconstruction in temporomandibular joint ankylosis: a systematic review and meta-analysis

Br J Oral Maxillofac Surg. 2022 Jul;60(6):731-739. doi: 10.1016/j.bjoms.2021.12.051. Epub 2021 Dec 15.

Abstract

This systematic review was planned to assess the clinical outcomes of transport distraction osteogenesis (TDO) compared with autogenous grafts for reconstruction of the ramus condyle unit (RCU). We searched Medline, Embase, Cochrane Library, Clinicaltrial.gov, and the references of included trials. The primary outcome was maximal incisal opening (MIO). Of the 148 studies retrieved, five were included (TDO = 49, autogenous grafts =123). The mean difference in MIO between TDO and autogenous graft RCU reconstruction, based on the random-effects model was 1.28 mm (95% CI 0.167 to 2.403) in favour of TDO. Re-ankyosis was observed in four cases in the costochondral graft group and none in the TDO group. Reconstruction of the RCU using TDO is comparable to autogenous grafts after the release of TMJ ankylosis, though the evidence is weak considering the small number of trials, high risk of bias, and absence of long-term results.

Keywords: RCU reconstruction; TMJ ankylosis; evidence synthesis; meta-analysis; systematic review; transport distraction osteogenesis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Ankylosis* / surgery
  • Arthroplasty / methods
  • Bone and Bones / surgery
  • Humans
  • Osteogenesis, Distraction* / methods
  • Temporomandibular Joint / surgery
  • Temporomandibular Joint Disorders

Supplementary concepts

  • Temporomandibular ankylosis