Fate of Free Fat Dermis Graft in TMJ Interpositional Gap Arthroplasty: A Long Term MRI Study

Introduction

Free fat dermis graft is a good interpositional material for TMJ gap arthroplasty. Analysing the fate of the graft by magnetic resonance imaging (MRI) images helps in excellent visualization of both bony and soft tissue anatomy of the operated TMJ joint as well as in assessing the changes in dermis graft which was previously placed.

Purpose of this Study

To investigate the radiological fate of the dermis-fat graft within the TMJ using MRI.

Materials and Methods

Five joints of five patients who had dermis-fat grafts placed in their TMJ following gap arthroplasty were recruited for this study. Each patient had undergone TMJ gap arthroplasty with immediate dermis-fat graft placement. All the patients are then subjected to MRI.

Results

Fat graft was identified in close proximity to the mandibular condyle in all cases, with only three joints demonstrating fat covering the entire articular surface of the mandibular condyle. In the remaining joints the interpositional material found in the MRI defined joint space with mainly grey appearance, suggesting tissue change to other than fat, i.e. scar or granulation tissue.

Conclusion

When free fat dermis graft is placed as interpositional material the graft occupied the entire TM joint and prevented it from recurrent ankylosis. The graft placed aids in normal functioning of the temperomandibular joint without any complications.