الفهرس 
Post-operative treatment and follow upOnly 14 pages are availabe for public view
Abstract
Following TMJ discectomy, any potential disc replacement material must satisfy several criteria. Long-term safety of the material must be assured to avoid the disasters of the 1980s caused by silastics. Intrinsic properties such as adequate bulk, easy handling and the ability to be sculptured intraoperatively to fit the joint cavity are desirable. A material that is abundantly available and easy to procure with minimal morbidity will encourage universal adoption of the technique.
Surviving the functional demands of the intra-joint environment and facilitating normal joint functions with reduced joint noises necessitates a material that is flexible enough to be able to adapt and change in response to the dynamic loads of the joint. The ideal material must also prevent bone formation and act as an effective barrier to joint ankylosis whilst protecting the underlying condyle from severe remodeling in the absence of a normal articular disc.
In reviewing the literature, it was clear that there is no ideal interpositional material that satisfies all the criteria for replacement of a missing articular disc following TMJ discectomy. The use of temporalis muscle and fascia, whilst the most popular of all interpositional materials, results in scarring and trismus from the donor site with the muscle undergoing degenerative fibrosis under compressive loading.For that issue; the aim of our study was to compare between two autogenous tissues; temporalis muscle flap and abdominal dermis-fat graft. Fourteen female patients were involved in the study. All patients had the same pre-operative preparations and they had the same surgical steps except for the tissue used to replace the disc after discectomy.
Patients were divided into two equal groups each containing seven patients. The study group had disc replacement with dermis fat grafts while the control group had disc replacement with temporalis muscle flap. Then all patients followed the same post-operative instructions and medications.
Follow up period for one year was allowed and subjects of both groups had been evaluated clinically and radiographically. Clinical results showed aesthetically acceptable scars, reduction of pain, increased maximum painless mouth opening, contralateral excursion and protrusion for both groups.
Radiographic results (MRI) showed stable dermis-fat graft along the follow up period as it showed adequate filling of the joint space, adequate coverage of the condyle also, changed in intensity from hyperintense to hypointense reflecting adaptive changes to the current joint loading. Temporalis muscle flap however showed less desirable results regarding filling the joint cavity.