The use of costochondral grafts in arthroplasty of the temporomandibular joint.

Replacement of the condyle with a costochondral graft restores the altered biomechanics after condylectomy or gap-arthroplasty procedures. It avoids the recurrence of ankylosis. In the child, this graft allows harmonious growth of the mandible due to the characteristics of the costochondral cartilage. A case of uncontrolled multidirectional and excessive growth of the graft during pregnancy supports the view that the costochondral junction also carries intrinsic growth properties. Long-term follow-up evaluation shows very satisfactory cosmetic and functional results. In patients neglecting postoperative jaw mobilisation, maximal interincisal opening is acceptable but remains low. If no posterior dental support is provided after restoring the vertical dimension with the graft, some degree of graft resorption is possible.