• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.69-77
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• 2006

Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.339-352
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• 2008

Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.152-157
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• 1998

Disturbances of the interrelationship among the host, environment, microorganism will cause the infection clinically. Infection can be classified into bacterial, viral, fungal origin, Bacterial infection is most common due to dental caries, periodontal disease. These infections have the potential to spread via the fascial spaces in the head and neck region. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing 78 hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Dong-A University Hospital from 1994 to 1997. The results were as fellows; l. Odontogenic infections were most common with the incidence of 84.6%. 2. Considering the number of involved space, single space was 83.3%, double or more space was 16.6%. The most common fascial space involved was submandibular space and followed by buccal space, 3. The most causative organism isolated from the pus cultures was streptococci group 35.4%. 4. Antibiotics were administrated in all cases, and surgical incision and drainage was performed in 87.2%. 5. Combined administration of penicillin and aminoglycoside was most common in 34.6%.. 6. 7 cases were diagnosed as Ludwig's angina and tracheostomy was done in 2 cases of them.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.67-80
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• 1989

The author studied the changes of muscle activity with Bioelectric processor Model EM2(Myotronics Corp., USA) before and after occlusal stabilization splint therapy. For this study, 15 temporomandibular disorders patients and 15 students without any temporomandibular disorders symptoms were selected, for experimental group and control group, respectively. Experimental group were treated with occlusal stabilization splint and checked about electromyographic activity before and after therapy. Electromyographic levels were measured in both groups at the following mandibular position, i.e., physiologic rest, tapping, light biting, hard open without pain, open with pain, right excursion and ipsilateral biting, left excursion and ipsilateral biting, protrusion, protrusive biting, edge biting and physiologic rest after movement. The obtained results were as follows : 1. In experimental group, post-treatment mean values of muscle activity were lower than pretreatment values. 2. In general, the pre-treatment mean values of muscle activity in experimental group were higher than those of control group. 3. In experimental group, no statistically significant difference appeared between affected and unaffected side. 4. The mean value of muscle activity in physiologic rest position after each movement check was lower than that before each movement check.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.375-385
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• 1999

타석에 관한 연구는 타석증을 보이는 환자에 대한 임상적 특징, 진단 및 치료에서부터 타석의 성분 및 구조 등에 이르기까지 다양한 범위에 걸쳐 이루어지고 있다. 타석의 미세구조에 관한 연구는 타석의 미세구조가 다양한 형태인 것으로 보고되고 있으며, 특히 최근 타석증의 치료에 새롭게 소개되고 있는 체외충격파쇄석술은 타석의 구조에 따라 그 효과가 영향을 받을 수 있을 것으로 사료된다. 이에 저자는 인간 타석의 미세구조에 관한 기본 자료가 필요할 것으로 사료되어 한국인 중년 여성으로부터 적출된 악하선 타석을 광학현미경 및 주사전자현미경을 이용하여 미세구조적 특징을 관찰한 결과, 다음과 같은 결론을 얻었다. 1. 타석은 중심부의 핵, 핵 주변의 층상구조 및 외피막으로 이루어져 있었다. 2. 핵은 비정형의 중심과 상대적으로 균질의 외곽부위로 구성되어 있었다. 3. 핵 주변은 대부분 동심원적인 층상구조를 보였지만 일부분에서는 균질의 구조를 보였다. 4. 타석 단면의 전체직경과 중심부 핵의 직경은 각각 $3,500{\mu}m$와 $1,500{\mu}m$였고, 층상구조를 이루는 각 층의 두께는 위치에 따라 약 $10{\sim}40{\mu}m$ 이내였다.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.689-699
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• 1996

The purpose of this research is to determine elements affecting the out-of-pocket cost of woman. The sample consisted of 1907 women living Iksan city. The survey was conducted by means of questionnaires. The model used in the analysis of out-of-pocket cost was the Andersen-Newman model, while the analysis techniques used were stepwise multiple regression and path analysis. The number of independent variables used in the analysis was 28 in total, ie 19 predisposing components, 6 enabling components, and 3 need components. In this study, the amount of variance by the model was 17 percent. Number of restricted activity days caused by oral disease, perceived susceptibility of dental disease, having a regular dental care, dental treatment costs, education level and income were found to have significant major effects on out-of-pocket cost. Number of restricted activity days caused by oral disease was the most important variable affecting out-of-pocket cost of woman. Also out-of-pocket cost shows larger effect due to enabling components than frequency of dental utilization.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.317-328
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• 2006

Purpose: This study was performed to measure the accuracy of adjustable dental impression trays by a scanning laser three-dimensional digitizer. Materials and Methods: Metal stock tray and adjustable stock trays were used for 40 stone casts(10 casts each) duplicated a resin master model of mandible and maxilla. The type IV dental stone was poured in a allginate impressions and allowed to set for one hour. The casts were digitized using an optical digitizer. The distance between the reference points were measured and analyzed on the graphic image of 3-D graphic software (CATIA version 5.0). The statistical significance of the differences between the groups was determined by a two-way ANOVA. Results: There were no significant differences between the accuracies of the adjustable stock tray and the master model except anterior arch width of the upper arch and the diagonal arch length and arch length(one side) of the lower arch. Conclusion: The adjustable stock trays showed clinically acceptable accuracies of the study casts produced by them.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.275-281
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• 2010

The lateral pterygoid muscle is one of the masticatory muscles basic to jaw function. Because of its deep location in the masticatory system, digital palpation of the muscle is usually difficult to perform and unreliable. Therefore, diagnosis of the myalgic disorders involving the lateral pterygoid muscle is a perplexing problem for clinicians. Local anesthetic injection can be a more effective method to examine the lateral pterygoid muscle for the purpose of discriminating the source of pain. Furthermore, immediate elimination of muscle pain facilitates stretching of the muscle in the full range. We report two cases of lateral pterygoid myalgia that were diagnosed and managed successfully through the use of intramuscular local anesthetic injection.

• Journal of Oral Medicine and Pain
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• v.15 no.1
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• pp.61-68
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• 1991

The author studied the changes of subjective, objective symptoms and muscle activities with EM2 (myo-tronics Co., Seattle, USA) before and after MRA therapy. The 11 patients were treated with MRA and active range of motion, pain and mouth opening limitation were checked at each visit for 6-8 weeks. Electromyographic activities were measured in both anterior lobe of temporalis and middle fibers of masseter at the position in rest, clenching and mastication. The obtained results were as follows : 1. There were significant decrease in pain and mouth opening limitation and significant increase in active range of motion after MRA therapy. 2. The muscle activities tended to decrease in general, especially in the temporal and masseter muscles on clenching and in the masseter on mastication after MRA therapy. 3. There were no significant differences in muscle activities between affected and unaffected side, but there was significant differences in temporal muscle on clenching side after therapy. 4. There were no significant differences in active range of motion, pain and mouth opening limitation between acute and chronic groups. 5. There was more significant decrease in muscle activities of the affected side in acute group than those in chronic group.

• Journal of Oral Medicine and Pain
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• v.16 no.1
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• pp.25-32
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• 1991

The author studied the changes of electromyographic activities of the masseter and anterior temporal muscles during maximal clenching before and after stabilization splint wearing. It also studied the changes of the symmetry of the muscle activity during maximal clenching. For this study, 15-healthy-female-students were selected. The obtained results were as follows : The EMG activities of right and left anterior temporal muscles and right masseter muscle during maximal clenching immediately after wearing of the stabilization splint were not changed compared with before wearing of the stabilization splint. The EMG activities of right and left masseter and anterior temporal muscles during maximal clenching were significantly increased after 1 week and 4 week-use of the stabilization splint(p<0.01). The asymmetric indices of the EMG activities of right and left masseter and anterior temporal muscles during maximal clenching immediately after wearing of the stabilization splint were not changed compared with before wearing of the stabilization splint. The asymmetric indices of the EMG activities of right and left anterior temporal muscles during maximal clenching were significantly decreased after 1 week and 4 week use of the stabilization splint(p<0.01). and that of masseter muscles showed a decreased tendency but there were no significant differences(p>0.05).