Composite temporalis pedicle flap as an interpositional graft in temporomandibular joint arthroplasty: a preliminary report.
Fifteen temporomandibular joint patients were evaluated preoperatively and postoperatively to evaluate the effectiveness of a composite (fascia, muscle and periosteum) temporalis pedicle flap as an interpositional disc replacement. A modified Craniomandibular Index (CMI) and Symptom Severity Index (SSI) were used to assess clinical and subjective symptoms. Eighteen months postoperatively there was a significant reduction in the CM and SS indices (P less than .001), with significant clinical improvement of the mandibular range of motion (P less than .05). However, a significant reduction of translation (P less than .01) was evident indicating that the increased mandibular opening was owing to a compensatory rotational movement. This study indicates that the composite temporalis pedicle flap is a good autogenous tissue for the reconstruction of the temporomandibular joint.
Dentofacial Deformities and Orofacial Pain Center, St Louis, MO 63117.
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EG
Herbosa
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KS
Rotskoff
D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008335:Mandibular Condyle / Q000503:physiopathology; D008875:Middle Aged; D009068:Movement; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery; D010521:Periosteum / Q000637:transplantation; D011859:Radiography; D012086:Reoperation; D013016:Sound; D013524:Surgical Flaps; D013703:Temporal Muscle / Q000637:transplantation*; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery