• 제목/요약/키워드: 과두걸림

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악관절 폐구성 과두걸림의 보존적 치료에 대한 장기적 평가 (Long-term Evaluation of Conervative Treatment for the Patients with TMJ Closed Lock)

  • Mi-Suk Seo;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • 제19권1호
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    • pp.93-103
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    • 1994
  • In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

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측두하악관절 주변인대 질환의 초음파영상 (Ultrasounds Image on the Disorders of the Ligaments Surrounding Temporomandibular Joints)

  • 홍수민;임영관;김병국
    • Journal of Oral Medicine and Pain
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    • 제33권4호
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    • pp.387-394
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    • 2008
  • 목적 : 측두하악장애 환자에서 고가의 자기공명영상 진단을 대신하여 상대적으로 경제적인 진단방법으로 고해상도 초음파 영상을 도입하는데 있어서 그 정확성과 유용성을 확인하고자 하였다. 방법 : 측두하악장애의 임상적 증상 중 과두걸림, crepitation과 함께 통증을 호소하는 20명의 환자를 대상으로 하였다. 고해상도 초음파 촬영을 시행하였고, 고해상도를 가진 초음파촬영시의 결과를 비교하기 위하여, 통상적인 방사선 사진인 측두하악관절의 횡두개 촬영을 Accurad X-200으로, 그리고 Dental CT를 촬영하였으며, 이를 임상소견과 더불어 비교항목으로 선택하였다. 고해상도 초음파의 진단학적 가지 평가를 위하여 통계학적으로 감수성, 특이성, 양성예상치, 음성예상치 및 정확도를 계산하였다. 결과 : 고해상도의 초음파 영상은 골관절염성 변화를 진단하는데 67.5%의 정확도를 보였으며, 관절원판의 위치변화를 진단하는데 92.5%를 보였으나, 관절 주변조직인 관절낭, 관절원판 후조직 그리고 주변 인대의 이상을 측정하는데 있어서 정확도가 55%를 나타내었다. 결론 : 향후 초음파 영상을 얻기 위한 적절한 기기의 발전과 고주파수의 transducer 등이 개발되고 시술자의 훈련과 경험이 쌓이게 되면 매우 우수한 그리고 비침습적이고 접근이 용이하며 경제적인 진단학적인 검사방법으로서 일반적인 도입이 가능할 것으로 사료된다.

폐구성 악관절 과두걸림환자의 하악회전운동에 관한 연구 (A study on the Rotational Torque Movement of Mandible in TMJ Closed Lock)

  • 김경;정성창;연태호
    • Journal of Oral Medicine and Pain
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    • 제22권2호
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    • pp.207-217
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    • 1997
  • This study was performed for Investigation of the magnitude of mandibular positional change in maximum mouth opening. protrusion, lateral excursion, gum and peanut chewing with BioPAK system(Bioresearch Inc. USA) which can analyze mandibular rotational torque movements. For this study 17 female patients with Temporomandibular joint(TMJ) closed lock and 18 female control without any Temporomandibular disorders(TMDs) signs and premature occlusal contact were included. The obtained results were as follows : 1. In maximum mouth opening, the mandibular rotational angle and distance of patients were significantly greater than those of control group in horizontal plane(P<0.05). 2. In protrusion, the mandibular rotational angle and distance of patients were significantly greater than those of control group in frontal and horizontal plane(P<0.01, P<0.05). 3. The mandibular rotational angle and 야stance in lateral excursion to affected side of patients were significantly greater than those in lateral excursion to non-affected side in frontal plane(P<0.05). 4. The mandibular rotational angle in gum chewing to affected side of patients was significantly greater than that in gum chewing to non-affected side in frontal plane. 5. The mandibular rotational angle and distance in peanut chewing to affected side of patients were significantly greater than those in peanut chewing to non-affected side in frontal and horizontal plane. 6. The mandibular rotational angle and distance in peanut chewing to affected side of patients were greater than those in gum chewing, and was the same result in control group in frontal and horizontal plane.

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