Interpositional arthroplasty has emerged as the preferred treatment for TMJA due to its ability to prevent re-ankylosis by inhibiting osteoblastic growth between the bone surfaces Studies by Wolford and Karras  have shown that autologous transplantation of abdominal fat around the TMJ reduces fibrosis and heterotopic bone formation, leading to improved range of motion Dimitroulis utilized a dermis fat graft from the groin for interposition in the TMJ however harvesting fat grafts from distant sites poses risks of morbidity and complications The BFP situated nearby the TMJ offers an alternative with ample volume and a dependable blood supply making it a logical choice for grafting without the need for distant site harvesting  Additionally  minimal changes in facial contour have been reported after the removal of the superior extension of the buccal fat pad which can be advantageous in cases of unilateral TMJA by addressing facial asymmetry

Roy et al compared the volumetric shrinkage of grafts and surgical outcomes favoring abdominal fat graft over pedicled buccal fat pad in treating TMJA Another study by Ejaz et al in 2022 evaluated masticatory function including bite force and chewing efficiency in patients with unilateral TMJ ankylosis treated with pedicled BFP interpositional arthroplasty alone Despite numerous studies on TMJA and graft materials individually there is limited direct comparison between pedicled BFP and free abdominal fat as interpositional grafts in terms of surgical outcome and  masticatory efficiency Therefore a prospective interventional study is warranted to compare the efficacy of these two methods This study is based on the hypothesis that there is no significant difference in surgical outcomes and masticatory efficiency in both free abdominal fat and pedicled BFP as an interpositional graft in TMJA patients