Aim of the study is to evaluate the efficacy of inter positional dermis-fat graft in the management of Temporo-mandibular joint(TMJ) ankylosis in children by assessing the maximal mouth opening prior and after procedure, complication at both donor and recipient sites, and prevention of re-ankylosis after inter positioning. Both unilateral, bilateral osseous and fibro-osseous ankylosis of both sexes in 5 patients and the age ranging from 5-12 years were included in this study . All the cases

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... . All the cases were treated with gap arthroplasty and the gap was filled with an autogenous abdominal dermis-fat graft procured from the supra pubic region. The dermis fat graft interpositional arthroplasty is a safe and effective procedure in the management of temporo-mandibular joint ankylosis which prevents re-ankylosis especially in children by minimizing the occurrence of excessive joint fibrosis and heterotopic calcification. .