ANESTHESIA/TMJ DISORDERS/FACIAL PAIN Is There a Difference in Volumetric Change and Effectiveness Comparing Pedicled Buccal Fat Pad and Abdominal Fat When Used as Interpositional Arthroplasty in the Treatment of Temporomandibular Joint Ankylosis? Q1 Q28 Ajoy Roychoudhury, MDS, * Surendra Acharya, MDS,y Ongkila Bhutia, MDS,z Ashu Seith Bhalla, MD, MAMS,x Smita Manchanda, MD,k and Ravindra Mohan Pandey, PhD{ Q27 Purpose: There is limited evidence in the literature about fat grafting in the management of temporo- mandibular joint ankylosis (TMJA). The purpose was to investigate which interpositional fat grafting tech- nique is superior in the operative management of TMJA. The specific aim was to compare the volumetric change and maximal mouth opening (MIO) when pedicled buccal fat or abdominal fat is interposed in pa- tients being treated for TMJA. Patients and Methods: A randomized controlled trial was conducted on TMJA patients divided into 2 groups: Pedicled buccal fat pad was used for interposition in group A, whereas abdominal fat was used in group B. At the end of 1 year, the volumetric change in fat was analyzed by comparing immediate postop- erative and 1-year follow-up magnetic resonance imaging (MRI). MIO and re-ankylosis were recorded. Cat- egorical variables were analyzed by the c 2 test or Fisher exact test. Continuous variables were compared using the t test and Wilcoxon signed rank test. Linear regression analysis was performed. Results: A total of 36 patients (51 joints [15 bilateral and 21 unilateral]) were included, comprising 18 in group A and 18 in group B. The mean preoperative MIO measured 6.8 mm in group A and 4.2 mm in group B. The mean immediate postoperative MRI fat volume was 4.3 cm 3 in group A and 10.8 cm 3 in group B. One-year follow-up MRI showed a fat retention rate of 32.44% in group A and 58.17% in group B. The rate of volumetric shrinkage was 67.5% in group A and 41.9% in group B(P < .001). Analysis of variance showed a statistically significant difference between volumetric shrinkage and both treatment groups (P < .001). MIO improved to 30.6 mm in the pedicled buccal fat pad group (group A) and 41.9 mm in the abdominal fat group (group B) (P < .001). No re- ankylosis occurred in either group at 1-year follow-up. Received from All India Institute of Medical Sciences, New Delhi, India. *Professor and Head, Department of Oral & Maxillofacial Surgery. yEx-Junior Resident, Department of Oral & Maxillofacial surgery. zProfessor, Department of Oral & Maxillofacial Surgery. xProfessor, Department of Radiodiagnosis. kAssistant Professor, Department of Radiodiagnosis. {Professor and Head, Department of Biostatistics. This study received funding from the Indian Council of Medical Research: SRF fellowship 3/1/2(7)/Oral/2015/NCD-II. Q7 Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest. Address correspondence and reprint requests to Dr Roychoud- hury: Department of Oral & Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, Room 111, New Delhi, India 110049; e-mail: ajoyroy@hotmail.com Received July 13 2018 Accepted March 5 2020 Ó 2020 Published by Elsevier Inc. on behalf of the American Association of Oral and Maxillofacial Surgeons 0278-2391/20/30231-7 https://doi.org/10.1016/j.joms.2020.03.006 1 FLA 5.6.0 DTD  YJOMS59116_proof  10 April 2020  2:10 pm  CE KO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112