Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Condylar and Ramal Vertical Asymmetry of Temporomandibular Disorders in Panoramic

파노라마 방사선사진을 이용한 측두하악관절장애 환자의 하악과두와 하악지 비대칭에 관한 연구

  • Jong, Ji-Woong (Dept. of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Kim, Byung-Gook (Dept. of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Kim, Jae-Hyung (Dept. of Oral Medicine, School of Dentistry, Chonnam National University)
  • 정지웅 (전남대학교 치과대학 구강내과학교실) ;
  • 김병국 (전남대학교 치과대학 구강내과학교실) ;
  • 김재형 (전남대학교 치과대학 구강내과학교실)
  • Published : 2005.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to examine the difference of condylar and ramal vertical asymmetric indices on paonramic radiographs between temporomandibular disorder patients and normal group and according to classification of temporomandibular disorders. One hundred and twenty temporomandibular disorder patients and thirty normal individuals were selected. After tracing the panoramic radiographs, measurements for asymmetric indices were identified. The means and standard deviations of the measurement of each group were calculated and compared between two groups. Through the comparison of the measurement between two groups, following results were obtained 1. As a result of comparing condylar and ramal vertical asymmetry indices of the temporomandibular disorder patients with that of normal group, there was significant difference in condylar vertical asymmetry index between two groups and no significant difference in ramal vertical asymmetry index between two groups. 2. Condylar and ramal vertical asymmetry indices of temporomandibular joint disorder and muscle disorder patients showed greater value than normal group, but there was no significant difference between temporomandibular joint disorder patients and muscle disorder patients. 3. Among temporomandibular joint disorder patients, muscle disorder patients, and normal group, there was only significant difference in condylar vertical asymmetry index between temporomandibular joint disorder patients and normal group. 4. Among disc displacement, disc dislocation with reduction, and disc dislocation without reduction, there were no significant difference in condylar and ramal vertical asymmetry indices. 5. There were no correlation between aging and condylar and ramal vertical asymmetry indices. The results of the present study showed that condylar vertical asymmetry index of temporomandibular disorder patients showed greater values than normal group, and this difference could be considered as the features of temporomandibular disorders. Thus measuring the condylar vertical asymmetry index on panoramic radiographs is considered as the important factor for diagnosis and treatment of temporomandibular disorders.

본 연구는 측두하악장애환자와 정상인 간 그리고 측두하악장애환자의 분류에 따른 하악과두와 하악지 비대칭지수를 파노라마 방사선사진에서 비교하여 측두하악장애환자의 진단 및 치료계획 수립에 도움이 되고자 본 연구를 시행하였다. 측두하악장애환자 120명과 정상인 30명의 파노라마 방사선사진을 촬영후, 투사도를 작성하였다. 그리고 파노라마 방사선사진 계측항목 계측치의 평균값과 표준편차를 측두하악장애환자와 정상인으로 구분하여 산출한 다음 비대칭지수식을 이용하여 비대칭지수를 산출하여 양군 간의 비교분석을 시행하여 다음과 같은 결과를 얻었다. 1. 측두하악장애군과 대조군 간 하악과두 수직비대칭지수는 유의한 차이를 보였으나, 하악지 수직비대칭지수에서는 유의한 차이를 보이지 않았다. 2. 관절장애군과 근육장애군의 하악과두 수직비대칭지수는 대조군에 비해 더 크게 나타났지만, 관절장애군과 근육장애군 간의 하악과두 수직비대칭지수는 유의한 차이를 보이지 않았다. 3. 관절장애군, 근육장애군, 그리고 대조군 간의 하악지 수직비대칭지수 비교에서는 군간 유의한 차이를 보이지 않았다. 4. 관절원판변위군, 정복성관절원판전위군, 그리고 비정복성관절원판전위군 간의 하악과두 그리고 하악지 수직비대칭지수 비교에서는 유의한 차이를 보이지 않았다. 5. 하악과두와 하악지 수직비대칭지수 모두 연령증가와 관련이 없었다. 이상의 결과는 측두하악장애군이 정상인에 비해 하악과두 수직비대칭지수가 높게 나타나, 이러한 차이가 측두하악장애와 관련이 있음을 시사하였다. 따라서 파노라마 방사선사진을 이용한 하악과두 수직비대칭지수 측정은 측두하악장애 진단과 치료시 고려해야 할 중요한 부분으로 사료된다.

Keywords

References

  1. Okeson JP. Management of Tempomandibular Disorders and Occlusion. 5th ed., St. Louis, 2003, Mosby
  2. Lund JP, Widmer CG. An evaluation of the use of surface electromyography in the diagnosis, documentation, and treatment of dental patients. J Craniomandib Disord 1988;3:125-137
  3. Mohl ND, Lund JP, Widmer CG, McCall WD Jr. Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. J Prosthet Dent 1990;63:332-336 https://doi.org/10.1016/0022-3913(90)90207-S
  4. Pullinger A, Hollender L. Assessment of mandibular condyle position: a comparison of transcranial radiographs and linear tomograms. Oral Surg Oral Med Oral Pathol 1985;60:329-334 https://doi.org/10.1016/0030-4220(85)90319-6
  5. Petersson A. Radiography of the temporomandibular joint. A comparison of information obtained from different radiographic techinques. Malo, Sweden, 1976, University of Malmo, pp. 500
  6. Smith SR, Matteson SR, Phillips C, Tyndall DA. Quantitative and subjective analysis of temporomandibular joint radiographs. J Prosthet Dent 1989;62:456-463 https://doi.org/10.1016/0022-3913(89)90181-9
  7. Mongini, F. The importance of radiotraphy in the diagnosis of TMJ dysfunction, A comparative evaluation of transcranial radiographs and serial tomography. J Prosthe Dent 1981;45:186 https://doi.org/10.1016/0022-3913(81)90339-5
  8. Tronje G. Image distortion in rotational panoramic radiography. Dentomaxillofac Radiol 1982; Suppl 3
  9. McDavid WD, Tronje G, Welander U, Morris CR. Mummikoski P. Imaging characteristics of seven panoramic x-ray units. Chapter 4. Horizontal and vertical magnification. Dentomaxillofac Radiol 1985;Suppl 8:29-34
  10. Ramstad T, Hensten-Pettersen O, Mohn E, Ibrahim SI. A methodological study of errors in vertical measurements of edentulous ridge height on orthopantomographic radiograms. J Oral Rehabil 1978;5:403-412 https://doi.org/10.1111/j.1365-2842.1978.tb01259.x
  11. Zach GA, Langland OE, Sippy FH. The use of the orthopantomogram in longitudinal studies. Angle Orthod 1969;39:42-50
  12. Welander U. A mathematical model of narrow beam rotation radiography. Acta Radiol 1974;15:307-315
  13. Lund TM, Manson-Hing LR. A study of focal troughs of three panoramic dental x-ray machines II. Image dimensions. Oral Surg Oral Med Oral Pathol 1984;58:736-741 https://doi.org/10.1016/0030-4220(84)90045-8
  14. Larheim TA, Svanaes DB. Johannessen S. Reproducibility of rotational panoramic radiographs with the orthopanotomograph 5: tooth length assessment. Oral Surg Oral Med Oral Pathol 1984;58:736-41 https://doi.org/10.1016/0030-4220(84)90045-8
  15. Larheim TA, Svanses DB. Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles. Am J Orthod Dentofac Orthop 1986;90:45-41
  16. Kjellberg H, Ekestubbe A, Kiliaridis S, Thilander B. Condylar height on panoramic radiographs. A methodologic study with a clinical application. Acta Odontol Scand 1994;52:43-53
  17. Habets LLMH, Bezuur JN, Van Ooij SP, Hansson TL. The Orthopantomogram, an aid in diagnosis of temporomandibular joint problems. I. The factor of vertical magnification. J Oral Rehabil 1987:14:475-480 https://doi.org/10.1111/j.1365-2842.1987.tb00742.x
  18. Habets LLMH, Bezuur JN, Naeiji M, Hansson TL. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil 1988;15:465-471 https://doi.org/10.1111/j.1365-2842.1988.tb00182.x
  19. Haber JD, Moss RA, Kuczmierczk AR, Garrett JC. Assessment and treatment of stress in myofacial pain dysfunction syndrome: a model for analysis. J Oral Rehabil 1983;10:187
  20. Schiffman EL, Friction JR, Haley D. The relationship of occlusion, parafunctional habits, and recent life events to mandibular dysfunction in a non-patient population. J Oral Rehabil 1992;19:201
  21. Christensen LV. Jaw muscle fatigue and pains induced by experimental tooth clenching: a review. J Oral Rehabil 1981;8:26-27
  22. Bezuur J. The recognition of craniomandibular disorders. Thesis. Academic Center for Dentistry, University of Amsterdam, The Netherlands
  23. Hansson TL, Nordstrom B. Thickness of the soft tissue layers and articular disk in temporomandibular joints with deviation in form. Acta Odontol Scand 1977;35:281-2888 https://doi.org/10.3109/00016357709064126
  24. Athanasiou EA, Melsen B, Mavreas D, Kimmel FP. Stomatognathic function of patients who seek orthognathic surgery to correct denotfacial deformities. Int J Adult Orthod Orthognath Surg 1989;4:239-254
  25. Costa. RL. Asymmetry of the mandibular condyle in Haida Indians. Am J Phy anthropol 1986;70;119 https://doi.org/10.1002/ajpa.1330700116
  26. Miller VJ. Condylar asymmetry and handness in patients wity temporomandibular disorders. J Oral rehabil 1997;24:247 https://doi.org/10.1111/j.1365-2842.1997.tb00322.x
  27. Miller VJ, Myers SL, Yoeli Z, Zeltser C. Condylar asymmetry and its relation to age in a group of patients with a craniomandibular disorder of mygenous origin. J Oral Rehab 1994;21:707 https://doi.org/10.1111/j.1365-2842.1994.tb01186.x
  28. Farr WB, McCarty WL Jr. A Clinical Outline of Tempomandibular Joint, Diagnosis and Treatment. 7th ed., Chicago, Quintessence Pub. Co., 1993
  29. Isbeg-Holm AM, Westesson P. Movement of the disc and condyle in temporomandibular joints with clicking: An arthrographic and cineradiographic study on autopsy specimen. Acta Odontol Scand 1982;40:151-164 https://doi.org/10.3109/00016358209012724