Temporomandibular joint arthroplasty comparison of autogenous versus alloplasts as interpositional material

Aim: to compare the post operative improvement in the opening of jaws after two procedures following,tmj gap arthroplasty and to compare early and late complications of the two procedures. methods: total forty patients were included in the study. 20 patients (group a) were treated with gap arthroplasty and temporal fascia graft while 20 patients (group b) were treated with gap arthroplasty and silastic graft. pre and postop jaw movements and interincisal openings of the two groups were noted with vernier calipers. 1,3 and 6 months follow ups were conducted. results: group a consisted of 13 males and 7 females while group b consisted of 12 males and 8 females. twentytwo out of forty patients had ankylosis of left side. mean preop interincisal distance was 4.65+/1.595 mm in 40 patients. the net increase in interincisal distance was 31.127 mm in group a and 31.260 mm in group b. both groups showed minimal complications but 4 patients from group a showed transient weakness of frontal branch of facial nerve while one showed frontal nerve injury on permanent basis. in group b 3 patients had infection post operatively,among these two patients recovered,where as one patient had rejection of alloplastic implant after one month. conclusion: the interposition of alloplastic graft (silastic) following arthroplasty of the tmj is less morbid than temporalis fascia interpositioning and gives equally good functional and aesthetic results.