Transport distraction versus costochondral graft for reconstruction of temporomandibular joint ankylosis: which is better?

Objective. This study compared the methods of transport distraction and costochondral graft in reconstruction of temporomandibular joint (TMJ) ankylosis. Study design. Bilateral bony TMJ ankylosis was induced in 12 adult goats. Transport distraction of the mandibular ramus was performed on one side, whereas costochondral graft was performed on the other side. Jaw movements, TMJ healing, condylar remodeling, and recurrence of ankylosis were assessed by clinical, radiological, and histological examinations. Results. Both transport distraction and costochondral graft established a neo-condyle separating from the pseudo-disc with a joint space. The ankylosis scores were higher in the distraction side in the first 12 weeks. Both techniques showed no significant difference in the calcification scores and recurrence of ankylosis in the long term. The maximal jaw movements in 3 directions returned to the pre-ankylosis stage by both methods. Conclusions. Distraction osteogenesis is an effective reconstruction method for TMJ ankylosis, matching the gold standard of costochondral grafting. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 32-40)