Autologous Fat Grafting in Total Temporomandibular Joint Replacement Surgery

CONTEXT: Alloplastic temporomandibular joint replacement. AIMS: To search for evidence for the use of periprosthetic autologous fat transplantation. SETTING AND DESIGN: Systematic review. MATERIALS AND METHODS: We searched in PubMed Central, Elsevier ScienceDirect Complete, Wiley Online Library Journals, Ovid Lippincott Williams and Wilkins, and Cochrane Library plus Results. Six studies reported improved results with the use of autologous fat graft (AFG) in patients treated with a total joint replacement, mainly about increased mobility. Three studies involved patients from the same surgeon with increased inclusions and increased follow-up period. A 1997 study by Wolford showed a significant difference in heterotopic bone formation between patients treated with AFG, compared to those who were not, indicating the potential and usefulness of AFG. CONCLUSION: A prospective multicenter randomized controlled trial of this promising concept is warranted before justifying common application because of the added morbidity and the questionable advantage.