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.