Top

Journal of Maxillofacial and Oral Surgery

Published in:

01-06-2021 | Magnetic Resonance Imaging | Original Article

Viability and Volumetric Analysis of Free Autogenous Dermis Fat Graft as Interpositional Material in TMJ Ankylosis: A Long-Term MRI Study

Authors: Mubashir Younis, Ajaz Shah, Irshad Ahmed

Published in: Journal of Maxillofacial and Oral Surgery | Issue 2/2021

Abstract

Aims and Objectives

Dermis fat graft has shown good clinical results as an interpositional material in temporomandibular joint (TMJ) ankylosis and prevents heterogeneous calcification following gap arthroplasty. However, survival of the graft and volume retention is still debatable. The main purpose of our study was to assess the viability of the graft, tissues changes associated with the graft and volume retention using magnetic resonance imaging (MRI).

Materials and Methods

Fifteen patients with TMJ ankylosis underwent gap arthroplasty followed by placement of abdominal dermis fat graft and were randomly divided into two groups. Group 1 was subjected to MRI analysis of the graft at 3–6 months and Group 2 was analyzed at 1–2 years post-operatively. The graft was evaluated using T1- and T2-weighed images along with fat suppression (FS) sequences in all the three planes and the volume was also calculated.

Results

Both Group 1 (7 patients and 11 joints) and Group 2 (8 patients and 13 joints) showed the presence of viable fat on T1 and T2 images, confirmed by FS images. Minor tissue changes were observed at the center of the graft in 5 patients of Group 1 and 3 patients of Group 2. Average volume of the graft was 4.154 cm³ at 3–6 months and 4.269 cm³ at 1–2 years, respectively, and when compared to the original volume of the graft (4.583 cm³ in Group 1 and 4.712 cm³ in Group 2), the difference was statistically insignificant (p > 0.005).

Conclusion

MRI shows long-term survival of autogenous dermis fat graft without significant volumetric reduction. This along with positive clinical results make dermis fat an excellent choice as an interpositional material for TMJ ankylosis.

Singh V, Dhingra R, Sharma B, Bhagol A, Kumar P (2011) Retrospective analysis of use of buccal fat pad as an interpositional graft in temporomandibular joint ankylosis: preliminary study. J Oral Maxillofac Surg 69:2530–2536CrossRef

Zhu S, Li J, Luo E, Feng G, Ma Y, Hu J (2011) Two-stage treatment protocol for management of temporomandibular joint ankylosis with secondary deformities in adults: our institution’s experience. J Oral Maxillofac Surg 69:565–572CrossRef

Yazdani J, Ghavimi MA, Pourshahidi S, Ebrahimi H (2010) Comparison of clinical efficacy of temporalis myofascial flap and dermal graft as interpositional material in treatment of temporomandibular joint ankylosis. J Craniofac Surg 21:1218–1220CrossRef

Li Z, Li ZB, Li JR (2007) Surgical management of posttraumatic temporomandibular joint ankylosis by functional restoration with disk repositioning in children. Plast Reconstr Surg 119:1311CrossRef

Chossegross C, Guyot L, Cheynet F, Blanc JL, Gola R, Bourezak Z, Conartht J (1997) Comparison of different materials for interposition arthroplasty in treatment of temporomandibular joint ankylosis surgery: long-term follow up in 25 cases. Br J Oral Maxillofac Surg 35:157–160CrossRef

Raveh J, Vuillemin T, Lädrach K, Sutter F (1989) Temporomandibular joint ankylosis: surgical treatment and long-term results. J Oral Maxillofac Surg 47(9):900–906CrossRef

Li ZB, Li Z, Shang ZJ, Zhao JH, Dong YJ (2006) Potential role of disc repositioning in preventing postsurgical recurrence of traumatogenic temporomandibular joint ankylosis: a retrospective review of 17 consecutive cases. Int J Oral Maxillofac Surg 35(3):219–223CrossRef

Long X, Li X, Cheng Y et al (2005) Preservation of disc for treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg 63(7):897–902CrossRef

Karamese M, Duymaz A, Seyhan N, Keskin M, Tosun Z (2013) Management of temporomandibular joint ankylosis with temporalis fascia flap and fat graft. J Craniomaxillofac Surg 41:789–793CrossRef

10.

Mehrotra D, Pradhan R, Mohammad S, Jaiswara C (2008) Random control trial of dermis-fat graft and interposition of temporalis fascia in the management of temporomandibular ankylosis in children. Br J Oral Maxillofac Surg 46:521–526CrossRef

11.

Dimitroulis G (2004) The interpositional dermis-fat graft in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 33:755–760CrossRef

12.

Shen P, Sun Q, Xu W, Zhen J, Zhang S, Yang C (2015) The fate of autogenous free fat grafts in the human temporomandibular joint using magnetic resonance imaging. J Craniofac Surg 43:1804–1808CrossRef

13.

Dimitroulis G, Trost N, Morrison W (2008) The radiological fate of dermis-fat grafts in the human temporomandibular joint using magnetic resonance imaging. Int J Oral Maxillofac Surg 37:249–254CrossRef

14.

Thangavelu A, Thiruneelakandan S, Hari Prasath C, Chatterjee D (2015) Fate of free fat dermis graft in TMJ interpositional gap arthroplasty: a long term MRI study. J. Maxillofac Oral Surg 14(2):321–326CrossRef

15.

Sawhney CP (1986) Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg 77(1):29–40CrossRef

16.

Choi M, Small K, Levovitz C, Lee C, Fadl A, Karp NS (2013) The volumetric analysis of fat graft survival in breast reconstruction. Plast Reconstr Surg 131(2):185–191CrossRef

17.

Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Md HT, Matsui H (2001) The fate of autogenous free-fat grafts after posterior lumbar surgery: part 1. A postoperative serial magnetic resonance imaging study. Spine 26:2258–2263CrossRef

18.

Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Tsuji H, Matsui H (2001) The fate of autogenous free-fat grafts after posterior lumbar surgery: part 2. Magnetic resonance imaging and histological studies in repeated surgery cases. Spine 26:2264–2270CrossRef

19.

Dimitroulis G, Slavin J, Morrison W (2011) Histological fate of abdominal dermis–fat grafts implanted in the temporomandibular joint of the rabbit following condylectomy. Int J Oral Maxillofac Surg 40(2):177–183CrossRef

20.

Sunaga A, Sugawara Y, Katsuragi-Tomioka Y, Kobayashi E (2013) The Fate of nonvascularized fat grafts: histological and bioluminescent study. Plast Reconstr Surg GlobOpen 1(6):e40CrossRef

Title: Viability and Volumetric Analysis of Free Autogenous Dermis Fat Graft as Interpositional Material in TMJ Ankylosis: A Long-Term MRI Study
Authors: Mubashir Younis
Ajaz Shah
Irshad Ahmed
Publication date: 01-06-2021
Publisher: Springer India
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Journal of Maxillofacial and Oral Surgery / Issue 2/2021
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI: https://doi.org/10.1007/s12663-020-01413-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Viability and Volumetric Analysis of Free Autogenous Dermis Fat Graft as Interpositional Material in TMJ Ankylosis: A Long-Term MRI Study

Abstract

Aims and Objectives

Materials and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aims and Objectives

Materials and Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2021

Lower Vestibular Incision: A Modified Technique of Dissection

Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction?

Authorship in Oral and Maxillofacial Surgery

COVID-19 and Mucormycosis of the Craniofacial skeleton: Causal, Contributory or Coincidental?

Evaluation of Airway Dimensions Following Mandibular Setback with Surgery-First Orthognathic Versus Conventional Orthognathic Approach

Microstomia Following Caustic Soda Ingestion: Report of a Case