Trial of a Sternoclavicular Whole Joint Graft as a Substitute for the Temporomandibular Joint

Autogenous grafts for condylar reconstruction in treatment of TMJ ankylosis: current concepts and considerations for the future

“…Sternoclavicular SNYDER et al reported the first sternoclavicular (SCJ) whole joint graft consisting of a portion of the manubrium, the intact capsule, and a portion of the clavicle on a 70-year-old man with cylindroma in 1971 77 . In 1986, REID et al reported a free-flap technique that included the clavicular head of the pectoralis major muscle and overlying skin, to provide a vascularized clavicular bone graft.…”

“…The head of the clavicle contains layers of cartilage that are similar to the mandibular condyle 96 . The SCJ articulation has a growth centre and an interarticular fibrocartilage articular disc that simulates the meniscus of the TMJ 11,17,77 . When a whole joint is used, the two adjacent synovial compartments and the strong fibrous capsule resemble those in the TMJ.…”

“…When a whole joint is used, the two adjacent synovial compartments and the strong fibrous capsule resemble those in the TMJ. Its absence is also of no great anatomical, functional, or aesthetic consequence 77 . Complete regeneration of the clavicle at the donor site has also been reported, significantly reducing patient morbidity postoperatively 75 .…”

Sternoclavicular Grafting a Pradigm Shift in the Management of TMJ Ankylosis

“…So to overcome these drawbacks sternoclavicular graft was tried. SCG in humans appears to be similar to the TMJ both anatomically and physiologically (snyder et al 1971) 21 The head of clavicle is composed of cartilage that is ontogenetically, phylogenitically, histologically and embryologically similar to cartilage of mandibular condyle (Gardner 1968; Ellis and Carlson 1986) 22 SCG articulation has a growth centre and interarticular fibro cartilaginous articular disc and stron fibrous capsule resembling TMJ. Complete regeneration at clavicle as in present study has been reported…”

Management of Juvenile Temporo-mandibular Joint Ankylosis by Gap Arthoplasty

“…Therefore, treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function. 4,5 Various autogenous grafts, including the metatarsus, 6 clavicle, 7 and iliac crest, 8 as well as various alloplastic materials, 9 have been used to reconstruct the TMJ. However, the free CCG has gained popularity in the past 2 decades 4.…”