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Online ISSN 1827-174X
Pelo S., Moro A., Mosca R., Boniello R.
Background. The study aimed to evaluate the possibility of using Bichat's fat pad as a free graft in the surgical treatment of ankylosis of the temporomandibular joint.
Methods. A retrospective study with a follow-up from 9 to 12 months was performed in six patients with ankylosis of the temporomandibular joint, for a total of nine joints treated at the Maxillofacial Surgical Unit of George Eastman Hospital in Rome. Five joints were treated using Bichat's fat pad and four with a myofacial flap of temporal muscle. Surgery was performed under general anesthesia. The ankylotic block was removed through a preauricular access and a graft was then inserted between the operated bone surfaces. All patients underwent a complete clinical examination to record maximum jaw aperture, lateral movements and protrusion. The following X-rays were also performed: tooth arches, bilateral temporomandibular stratigraphy in PA and LL projections; with mouth open and closed, and CT using an axial and coronal projection.
Results. The tests showed good functional recovery of the joint after arthrotomy and free pad graft. No patient showed lateral deviation in maximum aperture or postoperative malocclusion.
Conclusions. The technique used was simple and represents a valid alternative to other solutions. It is mainly indicated in the event of coronoidectomy concomitant to the removal of ankylosis or if the temporal muscle is not available.