Dermis fat graft compared to temporalis myofascial graft for interpositional arthroplasty in TMJ ankylosis. A systematic review and metanalysis

Abstract

This systematic review was performed to compare the dermis fat graft (DFG) to the conventional temporalis myofascial flap (TMF) used as Interpositional material in the management of temporomandibular joint ankylosis (TMJA). We searched PubMed, Embase, CENTRAL, clinical trial registries and google scholar. The outcomes of interest were Maximal Incisal Opening (MIO), Post-operative pain and reankylosis. Only four studies met the inclusion criteria. The studies had an overall high risk of bias. Nevertheless, the MIO was higher by 4.485 mm in DFG which was statistically significant (p < 0.01) but heterogenous (I² = 92%). The risk difference of reankylosis was only 3% less in DFG compared to TMF, which was statistically not significant (p = 0.64). The post-operative pain was comparable between the two techniques, with only one study reporting a statistically significant reduction in pain in the DFG group. We found low-quality evidence of statistically significant higher MIO in DFG, but a very low risk difference in reankylosis between the two techniques. Further clinical trials with long-term follow-up are recommended as the total sample and outcome events are very low for a concrete conclusion.