A Comparison of the Effect Between Coronoid Process Graft and Costochondral Graft in the Reconstruction of Temporomandibular Joint.

PURPOSE: Bone graft to reconstruct the temporomandibular joint for ankylosis patient is effective. This study used three-dimensional measurement to evaluate the effect between free coronoid process graft (CPG) and costochondral graft (CCG) in the temporomandibular joint reconstruction. METHODS: Patients treated with CPG or CCG from 2011 to 2014 were included in the study. Postoperative computed tomography scan data within 1 week and during at least 6 months follow-up after operation were imported into Proplan CMF 1.4 software (Materialize, Belgium) for three-dimensional reconstruction and measurement. Heights of the mandibular ramus were measured and compared between the 2 groups. Maximum mouth opening and occlusion were also evaluated and compared before and after operation. RESULTS: Ten patients with 15 reconstructed joints were included in the study. In the CPG group, the decrease of ramus height was 5.4 mm after a mean follow-up period of 16.8 months (ranged from 6 to 22 months), whereas in the CCG group, it was 2.4 mm after a mean follow-up period of 14.4 months (ranged from 6 to 30 months). There was significant difference of ramus height decrease between the CPG group and the CCG group (P < 0.05). Maximum mouth opening was significantly increased after operation than before in both groups (P < 0.05). Open bite happened in 4 of 5 patients in the CPG group, and 1 of 5 patients in the CCG group. CONCLUSIONS: CPG has higher frequency of a malocclusion secondary to resorption than CCG for the ramus reconstruction.