• 대한치과보철학회:학술대회논문집
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• 2000.04a
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• pp.39-39
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• 2000

• The korean journal of orthodontics
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• v.26 no.4
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• pp.423-439
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• 1996

The purpose of this study was to evaluate the diagnostic value of $SONOPAK^*$ in internal derangement of TMJ by comparing the spectral analysis data of TMJ sounds recorded by SONOPAK with the results of MRI. From the patients who came to Department of Orthodontics, Seoul National University Dental Hospital for treatment of malocclusion, eighteen adult patients (five males and thirteen females) with TMD symptoms were selected. After joint sounds were checked by a pediatric stethoscope, they were recorded and analyzed by the SONOPAK. The spectral analysis of the SONOPAK provided SONOPAK INTERPRETATION data about the stage of internal derangement, which were compared with the results of MRI. Among the patients whose disc positions were diagnosed as 'normar by MRI, there were no false positive diagnosis by the SONOPAK INTERPRETATION, But in the cases of anterior disc displacements (reducible and/or nonreducible), most of SONOPAK INTERPRETATION data did not coincide with MRI results. In conclusion, it is not adequate to try to differentiate reducible and non-reducible anterior disc displacements on the basis of joint sounds. And it is recommended not to determine the stage of internal derangement according to the nature of sounds. We suggest that the diagnostic value of the SONOPAK will be enhanced when clinicians combine some other informations such as clinical signs/symptoms and other supplementary diagnostic tools), and that more data be incoporated into the SONOPAK INTERPRETATION software.

• The korean journal of orthodontics
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• v.30 no.2 s.79
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• pp.235-243
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• 2000

Magnetic resonance imaging(MRI) of the temporomandibular joint(TMJ) is very useful method to diagnose internal derangement of the TMJ because of its high specificity foy identification of condyle-disc relationships. The purpose of this study was to evaluate the existence, incidence and severity o』 internal derangement o』 the TMJ by the MRI of Patients who are suspected to have TMJ disorder. MRI sample was composed of 50 subjects(10 males, 40 females) and the mean age was 22.9 years. 43 subjects of the sample were found to have positive findings. $56\%$ of the subjects with positive findings had ADD(anterior disc displacement) without reduction, and $65\%$ had internal derangement of bilateral joints. Distributions in the types of malocclusion in patients with positive findings, the Angle's classification had shown : the largest $41.9\%$ for Cl II ($39.6\%$ for Cl II div 1 and $2.3\%$ for Cl II div 2), $37.2\%$ for Cl I, $18.6\%$ for Cl III, and $2.3\%$ for the unidentified. $8.6\%$ of the subjects with positive findings had facial asymmetry and $55.8\%$ had openbite. We can conclude that the percentage of Cl II is the highest in patients with internal derangement of the TMJ. Openbite or facial asymmetry is considered to be uncompensated or compensated deformity which results from facial skeleton remodeling in the process of degenerative joint disease(DJD) due to TMJ degeneration. Therefore it is recommended to screen the patients with facial asymmetry or openbite by MRI before the beginning of orthodontic treatment. Differential diagnosis is essential because the tendency of relapse is high after the orthodontic treatment and continuous observation of TMJ is needed in patients with TMJ disorder.

• The korean journal of orthodontics
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• v.35 no.5 s.112
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• pp.398-407
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• 2005

The present study was conducted to examine the morphometrics and function of the disk on both sides among patients with facial asymmetry (FA) and to elucidate plausible correlations between internal derangement (ID) and FA. The sample was composed of 10 males and 27 females with FA. The disk status of all subjects was evaluated by bilateral high resolution magnetic resonance scans in the sagittal (closed and open) and coronal (closed) planes. Five types of disk displacement were identified accordingly. The disk function was diagnosed as normal disk function, disk displacement with reduction, and disk displacement without reduction. The disk shape on sagittal MRI in closed position was classified as bi-concave, biplanar, funnel/hemiconvex, and deformed. The disk position, translation and rotation were also measured. The difference between the shifted side and non-shifted side was analyzed by statistical analysis. Approximately $70\%$ of the patients in the present study showed unilateral or bilateral ID. It was found that anterior disk displacements (ADD), especially rotational ADD, occurred more frequently in the shifted side, while normal disk position was observed mainly in the non-shifted side (p<0.01). The disk of the shifted side showed significantly deformed configuration and inferior-anterior disk position. However, the disk of the non-deviated side showed hyper-mobility during jaw opening movement. These results demonstrate that in FA patients, the disks status of the shifted side is different from that of the non-shifted side, a phenomenon that could be correlated to facial asymmetry.

• The Journal of the Korean dental association
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• v.29 no.1 s.260
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• pp.73-82
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• 1991

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.11-18
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• 1989

Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.150-154
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• 1999

Fenestrated medial patellar plicae are unusual. These fenestrated medial plica may vary in size and shape from being small circular and 5mm in diameter to being large opening 3-4cm long. Arthroscopic resection of the painful medial plica can provide lasting and satisfactory relief of symptoms. There is high percentage of associated medial knee symptoms that are relieved by complete resection. We had performed arthroscopic excision of the symptomatic fenestrated medial plicae present in both knees. The symptoms were dramatically relieved after arthroscopic surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.453-457
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• 2006

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients' complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 ㏄) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.265-274
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• 2006

Temporomandibular joint (TMJ) internal derangement, especially disc displacement with reduction (DDwR) is the most common TMJ arthropathy and has been thought to do some effects on masticatory performance. Measuring of maximal bite force has been widely used as objective and quantitative method of evaluating masticatory performance, but previous studies showed various results due to various characteristics of subjects and different measuring devices and techniques. In a few studies about the correlation of bite force and temporomandibular disorders (TMD), some authors reported that bite force and masticatory performance would be reduced in patients with TMD because of pain. But the correlation of changes in structure of articular disc and masticatory performance has not been well investigated yet. In this study, to investigate the influences of non-painful disc change on the masticatory performance, we measured the value of maximal bite force, occlusal contact area and occlusal pressure of 39 patients with non-painful DDwR of the TMJ using pressure sensitive film, and compared it with that of 59 controls. The results are summarized as follows: 1. The maximal bite force (P<0.01) and the occlusal contact area (P < 0.05) of the DDwR patients were greater than the controls. 2. There was no significant difference in occlusal pressure between the DDwR patients and the controls (P > 0.05). 3. The maximal bite force of the male group was greater than that of the female group (P < 0.05). However, the occlusal contact area and the occlusal pressure between the male and the female group didn't show significant difference (P > 0.05). From the results above, we can suggest that DDwR could be a factor of changing bite force, but more controlled, large scaled and EMG related further study is needed.

• Journal of Oral Medicine and Pain
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• v.26 no.4
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• pp.345-353
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• 2001

Thermography는 신체 체표면에서 발생되는 온도를 정량화하는 다양한 방법에 대한 일반적인 표현이다. Electrothermography는 의학분야에서 사용이 증가되고 있는 술식이다. 인체를 포함한 모든 물체는 적외선을 방출한다. 그래서, Wien의 법칙에 따르면, 방출되는 최대에너지에서의 주파수는 체온에 의존한다는 것을 알 수 있다. 따라서, 피부 표면에서 방출되는 적외선을 측정하는 것에 의해 온도가 측정될 수 있다. 최근에는, electrothermography가 만성 구강안면동통 환자의 진단에 있어서 새로운 진단 기기로서 각광을 받고 있다. 본 연구에서는 측두하악관절장애의 증상이 있는 교근, 측두근, 그리고 측두하악관절의 발통점의 피부 온도와 증상이 없는 대측의 피부 온도를 디지틀 적외선 체열 촬영으로 비교하고자 하였다. 측두하악관절장애를 주소로 하고 편측성의 구강안면동통을 호소하는 21명의 내원환자를 선택하였다. 디지틀적외선 체열촬영은 DTI-16-DOREX21(Dorex Inc., U.S.A) 기기를 사용하였다. 발통점 피부에 marker를 부착하고, 좌측과 우측의 color thermogram을 $0.1^{\circ}C$ 해상도로 측정하였다. 본 실험에서 측정한 발통점은 masseter inferior, masseter anterior, temporalis anterior 그리고 TMJ이었다. 증상이 있는 부위와 증상이 없는 대측의 피부온도 차이를 알아보기 위해 paired t-test를 사용하였으며, 실험 결과는 다음과 같다. 1. 급성 근육장애 환자에 있어서는 증상이 있는 부위와 증상이 없는 대측과의 피부온도 차이가 통계학적으로 유의한 차이가 있었다(p<0.0075). 2. 만성 근육장애 환자에 있어서는 증상이 있는 부위와 증상이 없는 대측과의 피부온도 차이가 통계학적으로 유의한 차이를 볼 수 없었다. 3. 측두하악관절 내장증 환자에 있어서는 증상이 있는 부위와 증상이 없는 대측과의 피부온도 차이가 통계학적으로 유의한 차이를 볼 수 없었다. 결론적으로 적외선 체열촬영은 급성저작근장애의 진단에 있어서 유용한 진단방법의 한가지로 사료되며, 앞으로 임상적으로 더욱더 심화된 연구가 필요할 것으로 사료된다.