title: Temporomandibular Joint Discectomy With Abdominal Fat Graft Versus Temporalis Myofascial Flap: A Comparative Study.
abstract: OBJECTIVE
  Open temporomandibular joint (TMJ) arthroplasty with discectomy has been described as a primary surgical treatment and as a secondary treatment when minimally invasive procedures have failed. The aim of the present study was to compare TMJ discectomy with a fat graft versus TMJ discectomy with a temporalis graft using the pain score and maximal interincisal opening (MIO).
  
  
  METHODS
  We performed a retrospective study of patients who had undergone TMJ arthroplasty and discectomy with an abdominal fat graft or an interpositional temporalis flap at the University of Michigan from 1999 to 2014. The predictor variable was the type of surgical intervention. The main outcome variables were the pain score and MIO. Additional outcome variables were diet, medication use, the presence of myofascial pain, and occlusal outcomes. The statistical analysis included the mean ± standard deviation, a 1-way analysis of variance for continuous data, and Pearson's χ2test for categorical variables.
  
  
  RESULTS
  The study cohort included 50 patients, of whom 30 had undergone discectomy with a fat graft and 20 had undergone discectomy with a temporalis myofascial graft. The mean pain scores were decreased by 78.3% in the myofascial flap group and 52.8% in the fat graft group. Changes in MIO showed a statistically significant increase in the fat graft group but only approached statistical significance in the myofascial flap group.
  
  
  CONCLUSIONS
  The patients who had undergone TMJ arthroplasty and discectomy with a temporalis myofascial flap showed significantly greater improvement in pain scores and marginal improvement in the MIO compared with patients who had received an abdominal fat graft.
authors.affiliation: DDS Candidate, School of Dentistry, University of Michigan, Ann Arbor, MI. Electronic address: mdemerle@umich.edu.
authors.forename: Matt
authors.initials: M
authors.lastname: DeMerle
authors.affiliation: Assistant Professor, Division of Pediatric Anesthesia, Department of Anesthesiology, University of Michigan, Ann Arbor, MI.
authors.forename: Olubukola O
authors.initials: OO
authors.lastname: Nafiu
authors.affiliation: Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Sharon
authors.initials: S
authors.lastname: Aronovich
mesh_terms: D050153:Abdominal Fat / Q000637:transplantation*; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D013524:Surgical Flaps; D013703:Temporal Muscle / Q000637:transplantation*; D019224:Temporomandibular Joint Disc / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome