Sternoclavicular Graft Versus Costochondral Graft For Reconstruction ankylosed Temporomandibular joint in a child (Clinical and radiographic comparative study)

Abstract

Aim: To evaluate the feasibility of using sternoclavicular graft (SCG) versus costochondral graft (CCG) for TMJ reconstruction in TMJ ankylosis in child. Patients and methods:A total of 20 patients having unilateral bony TMJ ankylosis underwent gap arthroplasty then reconstruction of TMJ with SCG (Group I) or CCG (Group II). Pre-operative and post-operative clinical and radiographic evaluation were done to assess maximum mouth opening, range of mandibular movements, ramus height, donor and recipient sites complications for 24 month follow up at least.Results: Statistical analysis shows that postoperative measurements of different mouth movements increased comparing preoperative measurements in both groups without any significant difference between groups. While postoperative complications occurrence were higher in Group II than group I in pleural tear, pain, overgrowth, and facial asymmetry aspects with high statistical significant difference for pleural tear complication (p < 0.01). In opposite side, group I showed higher occurrence for skin scare as compared to group II with statistical significant difference. Postoperative radiographic assessment presented that the most measurements of both groups were better than the preoperative values without any statistical significant difference between groups (p> 0.05). Conclusion :The present study concludes SCG is a versatile and simple alternative graft to the traditional CCG for TMJ reconstruction with minimal complications in children with TMJ ankylosis.