title: Is autogenous abdominal fat transplantation into a large temporomandibular joint defect following removal of failed alloplastic prosthesis a definitive treatment?
abstract: OBJECTIVE
  To evaluate the long-term clinical outcome after the removal of failed major alloplastic temporomandibular joint (TMJ) implants and the placement of an autologous abdominal fat graft.
  
  
  METHODS
  A long-term clinical follow-up was performed in 4 patients who underwent removal of a failed alloplastic implant and insertion of an autologous abdominal fat graft under 1-stage surgical management. Postsurgical use of pain medication was documented and the vertical interincisal opening measurement was obtained at the follow-up visit. Long-term computed tomographic (CT) scans were available for 3 of 4 patients and evaluated for fat graft retention by a radiologist. Hounsfield units were used.
  
  
  RESULTS
  The study showed long-term (average, 4.7 years) clinical success, including normal jaw function (≥30-mm vertical opening) and freedom from the use of pain-relieving medication. Long-term CT scans (average, 5 years after surgery) documented fat graft retention in 3 patients (-80 HU).
  
  
  CONCLUSIONS
  Autogenous fat graft placement alone, after major TMJ alloplastic removal, provides excellent long-term clinical success.
authors.affiliation: Visiting Clinician, Division of Oral and Maxillofacial Surgery, Mayo Clinic College of Medicine, Rochester, MN; Professor, Department of Oral and Maxillofacial Surgery, University of Kirikkale, Kirikkale, Turkey. Electronic address: umutekin@gmail.com.
authors.forename: Umut
authors.initials: U
authors.lastname: Tekin
authors.affiliation: Consultant, Division of Oral and Maxillofacial Surgery, Mayo Clinic College of Medicine, Rochester, MN; Professor, Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Eugene E
authors.initials: EE
authors.lastname: Keller
authors.affiliation: Consultant, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN; Assistant Professor, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: David R
authors.initials: DR
authors.lastname: Delone
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000637:transplantation*; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D019643:Arthroplasty, Replacement; D064592:Autografts / Q000000981:diagnostic imaging / Q000637:transplantation*; D001672:Biocompatible Materials / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D007595:Joint Prosthesis / Q000009:adverse effects*; D008137:Longitudinal Studies; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000601:surgery; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D001672:Biocompatible Materials