Epidemiologic Study on the Patients Visited to Dept of Oral Medicine -In the Area of Choongnam-

구강내과 내원환자에 관한 역학조사 -충남지역에 대한-

  • Lee, Dong-Ju (Department of Oral Medicine, School of Dentistry, Dankook University) ;
  • Kim, Ki-Suk (Department of Oral Medicine, School of Dentistry, Dankook University)
  • 이동주 (단국대학교 치과대학 구강내과학교실) ;
  • 김기석 (단국대학교 치과대학 구강내과학교실)
  • Published : 2006.03.30

Abstract

Temporomandibular disorders (TMD) is a collective term embrassing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both. The prevalence of signs and symptoms associated with TMD can be best appreciated by examining epidemiologic studies. But domestic epidemiologic studies about sex, history, chief complaint, diagnosis were not sufficient comparing with foreign countries. The results obtained as follow. 1. The number of visiting patients were 6500 and mean age was 34.06 year (Male's mean age was 33.15, Female's 34.62). In the age of patients, there was no significant difference between sex. 2. There are most patients who were referred by dentist (80.07%). Most diagnostic group was arthrogenous TMD group and followed by myogenous TMD, soft tissue disease. 3. There was strong interaction between diagnostic groups and chief complaint. 4. There was little pain difference between right and left sides. Male mainly had pain onset under 6 month, but female had pain onset more than 6 month. 5. The number of patients who had joint sound history were 3445 (53.15%). There was no significant difference of pain onset between sex. Clicking sound was most among joint sounds which happened to patients. 6. In analyzing the parafunctional habit, male mainly had bruxism, but female had clenching habit.

측두하악관절장애에 관한 역학연구는 주로 1970년대 초 스칸디나비아국가에서 국민을 대상으로 무작위 추출법에 의한 악관절 및 저작계기능에 관한 역학조사로 시작되었으며 국내에서도 1970년대 이후 측두하악관절장애의 유병률에 대해 많은 역학연구가 보고되었다. 하지만 성, 병력, 주소, 진단에 따른 각각의 증상과 징후들을 평가한 연구는 외국에 비해서 많이 부족한 실정이다. 측두하악관절장애에 대한 증상과 진단에 관한 총괄적 연구조사는 오래전에 이루어진 것이 대부분이기 때문에 본 연구를 통해서 측두하악관절장애를 가진 환자들의 성, 병력, 주소, 진단에 따른 증상들을 총괄적으로 조사하여 향후 점증하는 측두하악관절장애환자의 진단과 치료에 도움이 되는 기초자료를 확보하고자 하였다. 본 연구결과를 보면 우선 연령의 경우 전체 내원 환자 6500명의 평균나이는 34.06세로 남자는 33.15세, 여자는 34.62세였으며 진단그룹별로 연령차이가 있었다. 의뢰 환자는 대체로 치과의사가 의뢰한 환자가 많았으며(80.07%), 의뢰한 환자 진단군은 관절성장애, 근육성장애, 연조직질환 순이었다. 전체 내원 환자 중 63%가 안면통증으로 내원하였으며, 발생부위에 대한 비교에서 좌우 유의한 차이를 볼 수 없었다. 또한 통증 발생은 6개월 미만에서는 주로 남성이, 6개월 이상인 경우는 여성의 비율이 상대적으로 높음을 알 수 있었다. 관절잡음의 경우 병력 환자는 3445명(53.15%)였으며, 발병시기에는 성차가 없었다. 관절잡음의 발생부위는 좌우 양측간에 차이가 없었으며 주로 clicking sound가 많음을 알 수 있었다. 이갈이는 주로 남자에서, 이악물기는 여자에서 나타났었다.

Keywords

References

  1. Okeson JP. Bell's Orofaical Pains : The Clinical Management of Orofacial Pain. 6th edition . 2005, Quintessence Publ Co, Inc
  2. 기우천, 최재갑, 윤창륙, 고명연 역. 구강안면 통증: 분류, 평가 및 치료를 위한 지침. 지성사, 서울, 1996
  3. Kaplan AS, Assael LA. Temporomandibular disorders : Diagnosis and treatment. 1991, W.B.Saunders Co, Inc
  4. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 5th edition. 2003, Mosby Co, Inc
  5. 정성창, 고명연, 김연중. 악관절 기능장애의 원인에 관한 연구. 대한구강내과학회지 1983;8:69-76
  6. C.McNeil. Management of temporomandibular disorders : Concepts and controversies. The Journal of Prosthetic Dentistry 1997;77:510-522 https://doi.org/10.1016/S0022-3913(97)70145-8
  7. Helkimo M. Studies on function and dysfunction of the masticatory system II. Swed Dent J 1974;67:100-109
  8. Kirsi Rauhala, Kyosti S, Oikarinen, Marjo-Ritta Jarvelin, Aune M Raustia. Facial pain and temporomandibular disorders : An epidemiological study of the Northern Finland 1966 Birth Cohort. Journal of Craniomanidubular Practice 2000;18:40-45
  9. Andeers Johansson, Lennart Unell, Gunnar E Carlsson et al. Association between social and general health factors and symptoms related to temporomandibular disorders and bruxism in a population of 50-year-old subjects. ACTA ODONTOL SCAND 2004;62:231-236 https://doi.org/10.1080/00016350410001649
  10. Andeers Johansson, Lennart Unell, Gunnar E Carlsson et al. Gender difference in symptoms related to temporomandibular disorders in a population of 50-year-old subjects. Journal of Orofacial Pain. 2003;17:29-34
  11. Lennart Lagerstrom, Inger Egermark, Gunnare Carlsson. Sign and symptoms of temporomandibular disorders in 19-year-old individuals who have undergone orthodontic treatment. Swedish Dental Journal Signs and Symptoms of Temporomandibular Disorders 2004;31:177-185
  12. R Akhter, Hassan, H Nameki, K Nakamura, O Honda. Association of dietary habits with symptoms of temporomandibular disorders in Bangladeshi adolescents. Journal of Oral rehabilitation 2004;31:746-753 https://doi.org/10.1111/j.1365-2842.2004.01420.x
  13. Olar Berhnardt, Dietmar Gesch, Christian Schwahn et al. Risk factors for headache, including TMD signs and symptoms, and their impact on quality of life. Results of the study of health in Pomerania. Quintessence int 2005;36:55-64
  14. BA Burt, JP Carlos, LK Cohen, R Dubner, JA Gershen, JC Greene. Advances in the epidemiological study of oral-facial diseases. Advance Dent Res 1989;3:30-41 https://doi.org/10.1177/08959374890030010301
  15. SY Chuang. Incidence of temporomandibular disorders (TMDs) in senior dental students in Taiwan. Journal of Oral Rehabilitation 2002; 29:1206-1211 https://doi.org/10.1046/j.1365-2842.2002.00968.x
  16. RG Jagger, SM Woolley. Signs and symptoms of temporomandibular disorders in Ecuadorian Indians. Journal of Oral Rehabilitation 2004;31:293-297 https://doi.org/10.1046/j.1365-2842.2003.01259.x
  17. O Berhnardt, D Gesch, C Schwahn et al. Signs of temporomandibular disorders in tinnitus patients and in a population-based group of volunteers : results of the study of health in Pomerania. Journal of Oral Rehabilitation 2004;31:311-319 https://doi.org/10.1046/j.1365-2842.2003.01249.x
  18. JP Goulet, GJ Lavigne, JP Lund. Jaw pain prevalence among French-speaking Canadians in Quebec and related symptoms of temporomandibular disorders. Journal of Dent Res 1995;74:1738-1744 https://doi.org/10.1177/00220345950740110401
  19. Gerald B Wexler, Michael W McKinney. Assessing treatment outcomes in two temporomandibular disorder diagnostic categories employing a validated psychometric test. Journal of Craniomandibular Practice 1995;13:256-262
  20. OD Otuyemi, D Orth, FJ Owotade et al. Prevalence of signs and symptoms of tempromandibualr disorders in young Nigerian adults. Journal of Orthodontics 2001;27:61-65 https://doi.org/10.1093/ortho/27.1.61
  21. Edmond HN, Katherine CM, Anne S Mcmillan. Prevalence of symptoms associated with temporomandibular disorders in Hong Kong Chinese. Journal of Orofacial Pain 2001;15: 228-233
  22. Greg Goddard, Hiroyuki Karibe. TMD prevalence in rural and urban native American populations. Journal of Craniomandibular Practice 2002;20:125-128
  23. Yuh-Yuan Shjau, Chueh Chang. An epidemiological study of temporomandibular disorders in university students of Taiwan. Community Den Oral Epidemiol 1992;20:43-47 https://doi.org/10.1111/j.1600-0528.1992.tb00672.x
  24. Etsuko Motegi, Haruyo Miyazaki, Isao Ogura et al. An orthodontic study of temporomandibular joint disorders Part 1: Epidemiological research in Japanese 6-18 years olds. The Angle Orthodontist 1992;62:249-255
  25. Jia-Kuang Liu, Min-Ywan Tsai. The prevalence of TMD in orthodontic patients prior to treatment at NCKUH in Southern Taiwan. The Functional Orthodontist 1996;November/ December:9-12
  26. 정성창,이승우,현기용. 악관절기능장애환자의 하악운동 및 임상적 증상.대한구강내과학회지 1985;10: 5-16
  27. 김선하,최재갑. 노인과 청년간의 측두하악장애증상 발현양상비교. 대한구강내과학회지 1989;14: 25-34
  28. 박미희, 고명연. Screening evaluation and predicting prognosis of craniomandibular disorder patients with the Solberg questionnaire. 대한구강내과학회지 1984;19(2):111-123
  29. 김미은,고명연. 두개하악장애환자의 임상양태에 관한 연구. 대한구강내과학회지 1993;18(2):29-41
  30. 김선희: 일반인에 있어서 측두하악장애의 인지도 조사에 대한 연구. 대한구강내과학회지 2000;25 (4):371-382
  31. 손대은,안용우,박준상,고명연. 간이설문을 이용한 측두 하악장애의 역학연구. 대한구강내과학회지 2000;29(4):341-351
  32. 김명희, 남동석. 한국인 부정교합자의 측두하악장애 유병율과 그 기여요인에 관한 연구. 대치교정지 1997;27(4):523-538
  33. JR Fricton, EL Schiffman. Reliability of a Crainomandibular Index. Journal of Dent Res 1986;64 (11):1359-1364
  34. Arey LB. Dorland's Illustrated Medical Dictionary. 23rd ed. Philadeplhia. 1960, W.B. Saunders Co,Inc
  35. J Ahlberg, A Savolaninen, M Rantala et al. Reported bruxism and biopsychosocial symptoms : a longitudinal study. Community Dent Oral Epidermiol 2004;32:307-11 https://doi.org/10.1111/j.1600-0528.2004.00163.x
  36. Thomas List, Kerstin Wahlund, Bengt Wenneberg, Samuel F. TMD in children and adolescents: Prevalence of pain, gender differences, and perceived treatment need. Journal of Orofacial Pain. 1999;13:9-18
  37. Manabu Kamisaka, Hirofumi Yatani, Yoshizo Matsuka, Hajime Minakunchi. Four-year longitudinal course of TMD symptomsin an adults population and the estimation of risk factors in relation to symptoms. Journal of Oral Pain 2000;14(3):224-231
  38. Thuan TT Dao. Gender differences in pain. Journal of Orofacial Pain 2000;14:169-184
  39. John P. Hatch, John D Rugh, Shiro Sakai et al. Is use of exogenous estrogen associated with temporomandibular signs and symptoms. JADA. 2001;132:319-326
  40. Berit Schie Krogstad, Asbjorn Jokstad, Bjorn L Dahl, Olav Vassend. The reporting of pain, somatic complaint, and anxiety in a group of patients with TMD before and 2 years after treatment : sex differences. Journal of Orofacial Pain 1996;10:263-269
  41. H Nourallah, A Johansson. Prevalence of signs and symptoms of temporomandibular disorders in a young male Saudi population. Journal of Oral Rehabilitation 1995;22;343-347 https://doi.org/10.1111/j.1365-2842.1995.tb00783.x
  42. R Miyake, R Ohkubo, J Takehara. Oral parafunctions and association with symptoms of temporomandibular disorders in Japanese university students. Journal of Oral Rehabilitation 2004;31:518-523 https://doi.org/10.1111/j.1365-2842.2004.01269.x
  43. Kazuo Tanne, Eiji Tanaka, Mamoru Sakuda. Association between malocclusion an temporomanidular disorders in Orthodontic patients before treatment. Journal of Oral Pain 1993;7(2):156-161
  44. Marjaana Kuttila, Paivi M Niemi, Seppo Kuttila et al. TMD treatment need in relation to age, gender, stress, and, diagnostic subgroup. Journal of Orofaical pain 1998;12:67-74
  45. Robert Ferrari, Myers. Leonaro. Whiplash and temporomandibular disorders: A critical review. JADA 1998;129:1739-1745
  46. A Gavish, M Halachmi, E Winocur, E Gazit. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. Journal of Oral Rehabilitation 2000;27 :22-32 https://doi.org/10.1046/j.1365-2842.2000.00484.x