Is autogenous abdominal fat transplantation into a large temporomandibular joint defect following removal of failed alloplastic prosthesis a definitive treatment?

PURPOSE: To evaluate the long-term clinical outcome after the removal of failed major alloplastic temporomandibular joint (TMJ) implants and the placement of an autologous abdominal fat graft.

MATERIALS AND METHODS: A long-term clinical follow-up was performed in 4 patients who underwent removal of a failed alloplastic implant and insertion of an autologous abdominal fat graft under 1-stage surgical management. Postsurgical use of pain medication was documented and the vertical interincisal opening measurement was obtained at the follow-up visit. Long-term computed tomographic (CT) scans were available for 3 of 4 patients and evaluated for fat graft retention by a radiologist. Hounsfield units were used.

RESULTS: The study showed long-term (average, 4.7 years) clinical success, including normal jaw function (≥30-mm vertical opening) and freedom from the use of pain-relieving medication. Long-term CT scans (average, 5 years after surgery) documented fat graft retention in 3 patients (-80 HU).

CONCLUSION: Autogenous fat graft placement alone, after major TMJ alloplastic removal, provides excellent long-term clinical success.