J Korean Assoc Oral Maxillofac Surg.  2021 Apr;47(2):128-134. 10.5125/jkaoms.2021.47.2.128.

Temporomandibular joint reconstruction with costochondral graft: case series study

• Choi MG

• KMID: 2515311
• DOI: http://doi.org/10.5125/jkaoms.2021.47.2.128

Abstract

Various techniques have been used to reconstruct the temporomandibular joints, including autogenous transplants and alloplastic implants. Among autogenous grafts, costochondral grafts have mainly been used. A costochondral graft has many advantages over other autogenous grafts and alloplastic implants. Harvest is easy and has minimal impact on patients. The graft can bear functional load well and biocompatibility is excellent. A costochondral graft obviates foreign body reactions and further surgery for revision of alloplastic replacements if the graft takes well. Although long-term prognosis remains unclear, it appears that for autogenous condylar reconstruction, costochondral grafts can be used with few complications and acceptable results. This article describes cases and discusses surgical techniques and considerations related to costochondral grafts.

Keyword

Costochondral graft; Temporomandibular joint; Autogenous graft

Figure

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  Fig. 1 On computed tomography, bilateral intracapsular condylar fractures were observed.

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  Fig. 2 A. Trimmed end portion of the costochondral graft loosely contacted the temporomandibular joint in the centric occlusion state. B. Trimmed end portion of the costochondral graft moved along the articular fossa as mouth opening increased.

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  Fig. 3 A, B. On three-dimensional computed tomography, the costochondral graft was fixed in a good position. C. On coronal plane view, costochondral grafts were positioned on the lateral surface of the articular fossa.

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  Fig. 4 At the last visit, the patient showed near normal mandibular excursion and protrusion.

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  Fig. 5 On computed tomography, submasticatory space abscess and bony destruction were observed around the condyle and ramus.

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  Fig. 6 On computed tomography, right and left condylar fractures were level 2, but there were multiple fragments on the left side.

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  Fig. 7 The right condyle was fixed openly, and the left condyle was reconstructed with a costochondral graft. The cartilage portion of the graft was positioned well into the condylar fossa.

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  Fig. 8 Patient showed limited mandibular excursion, but maximum mouth opening was 45 mm in length.

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  Fig. 9 On computed tomography, submasticatory space abscess and bony destruction were observed around the condyle and ramus.

Reference

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