Background and objectives: Costochondral graft can be performed in adults and children, for the treatment of mandibular hypoplasia or for temporomandibular joint replacement in congenital (otomandibular dysplasia) or acquired disorders (ankylosis, degenerative joint disease).

Methods: 74 costochondral grafts were performed in our department since 1990 and analyzed retrospectively. Delaire’s cephalometric analysis on lateral cephalometric X-rays was performed and the interincisal opening (IIO) was measured. Post-operative complications were recorded within the first year post surgery (immediate complications) and beyond the first year (late complications).

Results: IIO was significantly improved in patients with severe TMJ dysfunction (preoperative IIO = 8.7 mm, postoperative IIO = 24.7 mm, p = 0.002). The ramus was significantly lengthened in a stable manner (9 mm, p < 0.0001). Postoperative immediate complication was infection, whereas late postoperative complications were overgrowth of the graft and the recurrence of the disease.

Conclusions: Those results are similar to data from literature. Other available methods (TMJ prostheses, distraction osteogenesis) can be proposed depending on the age of the patient, the joint damage and the posterior vertical insufficiency.