Effectiveness of Dermis Fat Graft Versus Temporalis Myofascial Flap for Interposition in Temporomandibular Joint Ankylosis: A Systematic Review

J Maxillofac Oral Surg. 2023 Jun;22(2):321-328. doi: 10.1007/s12663-023-01869-9. Epub 2023 Mar 10.

Abstract

Background: Temporomandibular joint ankylosis is a disabling condition which affects joint movements causing difficulty in speech, mastication and hygiene. Over time various interposition materials like meniscus, muscle, fascia, skin, cartilage, fat, dura and alloplastic materials have been used for the treatment of ankylosis and improve joint functions.

Objective: The objective of this systematic review is to evaluate the effectiveness of dermis fat graft and temporalis myofascial flap as an interpositional material in treatment of temporomandibular joint ankylosis and to compare the effectiveness of the two materials.

Materials and methods: PubMed, Google scholar, and Cochrane library search in combination with hand search of relevant journals were conducted published in English from January 2000 to August 2021. Randomized controlled trials, prospective and retrospective cohort studies were included. Outcome measure included improvement in mouth opening. Risk of bias assessment was assessed using Cochrane risk of bias tool and Newcastle-Ottawa scale.

Results: A total of 144 articles were found from the primary search which on thorough assessment, duplicate and exclusion removal resulted in 9 cohort studies and 1 randomized controlled trial that fulfilled the inclusion criteria. All the studies included reported significant improvement in mouth opening after interposition of the 2 materials. Four studies compared temporalis myofascial flap with dermis fat graft, 2 studies reported dermis fat graft gives better outcomes, whereas 1 study reported temporalis myofascial flap to be better and 1 study has been inconclusive.

Conclusion: Definitive conclusions cannot be drawn as there are number of limitations in the studies included. However a general consensus has been toward dermis fat graft owing to fewer complications.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-023-01869-9.

Keywords: Dermis fat graft; Maximal incisal opening; Temporalis myofascial flap; Temporomandibular joint ankylosis.

Publication types

  • Review