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Updated: Jun 17, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
[The use of Bichat's fat pad in temporomandibular joint surgery. First evaluation]
1Ospedale George Eastman-Roma, Unità Operativa di Chirurgia Maxillo Facciale.
Background:
The study aimed to evaluate the possibility of using Bichat's fit pad as a free graft in the surgical treatment of ankylosis of the temporomandibular joint.
Methods:
A retrospective study with a follow-up from 9 to 12 months was performed in six patients with ankylosis of the temporomandibular joint, for a total of nine joints treated at the Maxillofacial Surgical Unit of George Eastman Hospital in Rome. Five joints were treated using Bichat's fat pad and four with a myofacial flap of temporal muscle. Surgery was performed under general anesthesia. The ankylotic block was removed through a preauricular access and a graft was then inserted between the operated bone surfaces. All patients underwent a complete clinical examination to record maximum jaw aperture, lateral movements and protrusion. The following X-rays were also performed: tooth arches, bilateral temporomandibular stratigraphy in PA and LL projections,; with mouth open and closed, and CT using an axial and coronal projection.
Results:
The tests showed good functional recovery of the joint after arthrotomy and free pad graft. No patient showed lateral deviation in maximum aperture or postoperative malocclusion.
Conclusions:
The technique used was simple and represents a valid alternative to other solutions. It is mainly indicated in the event of coronoidectomy concomitant to the removal of ankylosis or if the temporal muscle is not available.
