title: Reconstruction of the temporomandibular joint using a temporalis graft with or without simultaneous orthognathic surgery.
abstract: OBJECTIVE
  This article reports the outcome of free temporalis fascia and muscle graft (TFG) reconstruction of the temporomandibular joint (TMJ) with and without simultaneous orthognathic surgery (SOS).
  
  
  METHODS
  Twenty-nine patients (45 joints) were evaluated retrospectively. Group 1 consisted of 17 patients (16 women 1 man) and 30 joints. Fifteen (88%) patients had sagittal split ramus osteotomies (SSRO); 8 (53%) of these patients also had Le Fort I osteotomies, and 2 patients (12%) had only Le Fort I osteotomies with TFG. Group 2 consisted of 12 patients (15 joints) who received only TFG and no SOS.
  
  
  RESULTS
  Group 1 had 9 patients (53%) with an incisal opening greater than 35 mm, 11 joints (37%) with greater than 6 mm lateral excursive movement, and 11 patients (65%) were asymptomatic postoperatively. Average follow-up was 57.4 months (range, 23 to 69 months). Group 2 had eight patients (67%) with an incisal opening greater than 35 mm, six joints (40%) with greater than 6 mm lateral excursive movement, and seven patients (58%) were asymptomatic postoperatively. Average follow-up was 55.1 months (range, 48 to 64 months).
  
  
  CONCLUSIONS
  TFG with and without SOS produced similar treatment outcomes in comparing groups 1 and 2. No significant differences were observed for the number of patients with an incisal opening > 35 mm (P = .703), lateral excursion > 6 mm (P = 1.00), and successful elimination of pain (P = 1.00), even though group 2 had a significantly greater number of patients (P < 0.01) that were operated on unilaterally. Combining treatment outcomes for both groups, the number of previous joint surgeries significantly affected success (P < .01). The presence of osteoarthritic changes did-not significantly affect treatment outcome (P = .187).
authors.affiliation: Baylor University Medical Center, Dallas, TX, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Henry
authors.forename: L M
authors.initials: LM
authors.lastname: Wolford
mesh_terms: D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000601:surgery; D016009:Chi-Square Distribution; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D016013:Likelihood Functions; D008297:Male; D008310:Malocclusion / Q000601:surgery; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D010003:Osteoarthritis / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D013703:Temporal Muscle / Q000637:transplantation*; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome