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| Auteurs principaux: | , , , , , |
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| Format: | Recurso digital |
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Zenodo
2026
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| Accès en ligne: | https://doi.org/10.5281/zenodo.20101675 |
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Table des matières:
- PURPOSE: A systematic review was conducted comparing outcomes and complication profiles in TMJ arthroplasty requiring interpositional graft between adult and pediatric populations. METHODS: A systematic review and meta-analysis collecting data on patients who underwent TMJ arthroplasty with an interpositional graft was conducted following Joanna Briggs Institute guidelines and PRISMA-ScR reporting standards. PubMed, Embase, and Web of Science were searched through July 2025 for English reports of individual TMJ cases. Data on demographics, interposition material, surgical indication, complications, and follow-up from 43 studies were compared between pediatric and adult patients. Pre- and postoperative maximal incisal opening (MIO) values were pooled using inverse-variance weighting. RESULTS: This review comprised 436 adult patients (age range: 18-80) and 315 children (age range: 1-17). Among 43 studies, 51% (n=22) included solely adult cases, 44% (n=19) solely pediatric cases, and 16% (n=7) included both. The weighted mean pre- and post-op MIOs for adult patients was 12.93 and 30.4 compared to 5.5 and 33.3 for children (p<0.05). The risk of postoperative infection was markedly elevated in children (5% vs 0.7% in adults), an approximate 7.4-fold increase in risk (OR=0.129, p=0.0002). Incidence of reankylosis was significantly higher in children (6% vs 1%), a 5.8-fold increase (OR=0.171, p=0.0001). Graft overgrowth was observed exclusively in the pediatric cohort (5.4% vs 0%). Facial nerve injury occurred at comparable rates (9% adults vs 6% children). Among adult patients, abdominal fat graft had the highest success rate (97%), followed by costochondral graft (96%) and temporalis interposition (95%). CONCLUSION: Children exhibited greater MIO improvement than adults but heightened risks of infection, reankylosis, and graft overgrowth, underscoring the need for preoperative family counseling and closer postoperative surveillance.