Autogenous Fat as an Ideal Interpositional Material in Temporomandibular Joint Surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Temporomandibular joint (TMJ) ankylosis is commonly treated with interpositional gap arthroplasty.
• Autogenous tissues are favored over alloplastic and xenograft materials due to better integration and cost-effectiveness.
• Historically, various tissues like muscle, fascia, and cartilage were used for interposition.

Purpose of the Study:

• To review the historical use of different autogenous tissues in TMJ ankylosis surgery.
• To highlight the increasing preference for autogenous fat as an interpositional material.
• To present the advantages of autogenous fat in TMJ reconstruction.

Main Methods:

• Literature review of surgical techniques and materials used in TMJ ankylosis.
• Analysis of the evolution of autogenous tissue graft selection for TMJ reconstruction.
• Focus on the transition towards using autogenous fat (abdominal and buccal fat pad) in recent decades.

Main Results:

• Autogenous fat, particularly from the buccal fat pad, has become the most favored material for TMJ ankylosis surgery and total joint replacement (TMJ-TJR).
• The shift towards autogenous fat is attributed to its bioavailability, ease of uptake, local availability (for BFP), and pedicled nature.
• Buccal fat pad (BFP) offers advantages of local availability and a pedicled nature, simplifying its use.

Conclusions:

• Autogenous fat represents a significant advancement in TMJ ankylosis treatment, offering superior outcomes.
• The use of autogenous fat, especially the buccal fat pad, is increasingly adopted due to its favorable characteristics.
• This review supports the continued use and further investigation of autogenous fat in TMJ reconstruction.