CLINICAL AND COMPUTED TOMOGRAPHIC FINDINGS IN COSTOCHONDRAL GRAFTS REPLACING THE MANDIBULAR CONDYLE

Purpose: The aim of this study was to evaluate by computed tomography (CT) and clinically the structure and function of costochondral grafts (CCG) used to replace the mandibular condyles. Material and Methods: CT and clinical examination were performed in 11 patients with CCGs (9 female, 2 male; mean age at surgery, 25 years; range, 9 to 44 years) approximately 4.5 years after surgery (range, 5 months to 10.5 years), One mandibular condyle was replaced in six patients and two in five p atients. Results: Facial asymmetry was observed in two cases and palpa tion tenderness TMJs or clicking and crepitation were found in 10 of 1 6 operated TMJs, In three cases coronal CT scans showed the graft to b e situated laterally in the mandibular fossa, and lateral overgrowth o f the graft was seen in three cases, In two cases, coronal CT slices s howed that a new fossa had developed. In most cases translatory moveme nt of the graft was minimal. The graft was either partially or almost completely mineralized, especially in cases with longer follow-up. Con clusions: Most of the patients in this study seemed to have benefitted from replacement of the deformed mandibular condyle with a CCG as est imated by improved range of mandibular movements and decreased symptom s. There were some problems related to unpredictable growth and locati on of the graft, as well as restricted movement of the replaced condyl e, In the future, care should be taken to ensure proper postoperative functional therapy and to examine the role of cartilage thickness on f uture growth in young patients.