• Title/Summary/Keyword: 안면통

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The Development of Classification System of Dental Services for Temporomandibular Joint Disorders (측두하악장애 의료행위분류에 관한 연구)

  • Song, Yun-Heon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.257-268
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    • 2005
  • It is recently suggested in Korea that Resource-Based Relative Value Scale (RBRVS) is an alternative plan of Korean Dental Fee Schedule which has been operated on a fee-for-service basis since the introduction of the national health insurance program in 1977. RBRVS applicable to diagnosis and treatment for temporomandibular disorders (TMD), a common cause of orofacial pain, is needed to be estimated in Korea and the establishment of the standard terminology of dental procedures for TMD should be preceded. The purposes of this study were to develop a new classification system of health care service items for TMD and to investigate time needed for each item, which enables RBRVS to be estimated prior to establishment the payment system of health care services for TMD. The dental service items for TMD in this study were categorized through Delphi process which 10 TMD specialists were participated in and the time needed for each service item was investigated by work sampling and time study method with a stopwatch. The results of this study demonstrated the new classification system of dental services for TMD comprising 151 service items and exhibited the average time for each items ranging from 7.22 min for cold laser therapy to 171.71 min for direct fabrication of anterior repositioning splint. Conclusively, it is suggested that the classification system for TMD developed in this study, considering specific characteristics on basis of resources for health care service of dental procedures, should be helpful to estimate payment level for each service item.

Combination Radiation and Steroid Therapy for Midline Granuloma (Midline Granuloma의 방사선 치료 및 Steroid병용요법)

  • 강현영;박준식
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.3-15
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    • 1981
  • Midline Granulcma(Malignant midline reticulosis) of upper respiratory tract was known as one of the fatal diseases that involve the nasal cavity, paranasal sinuses, pharynx and larynx, with progressive localized necrotizing inflammation and granuloma formation. The disease was first described in 1897 by McBride and after Stewart many clinical and histological studies have been done in 1933. But its etiology is still unclear and therapeutic methods are still under development. The authors carried out a clinical study of 15 cases which were diagnosed and treated as midline granuloma, including 7 cases which received combination radiation and steroid therapy from January 1964 to December 1980. The results are as follows: 1) Age and Sex distribution: 6 cases fell into the ages from 30 to 39 years: 13 cases (87%) were male and 2 cases (13%) were female. 2) Primary lesion sites were nasal cavity and paranasal sinuses area (8 cases: 53%), palatine tonsil (3 cases: 20%) and pharynx (2 cases: 13%) in order. 3) Common symptoms were nasal stuffiness and sore throat (6 cases: 40%), headache (5 cases: 33%), nasal discharge and facial edema (3 cases: 20%) in order. 4) Microorganisms were identified in 4 cases: staphylococcus in 2 cases, pseudomonas in 1 case and streptococcus in 1 case. 5) All 7 cases who received combination radiation and steroid therapy revealed complete regression and no recurrence. 6) Among the 5 cases, who received steroid and antibiotic therapy, 2 cases died and other 3 cases improved temporarily and then developed aggrevation of symptoms.

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Evaluation of Quality of Life according to Temporomandibular Disorder Symptoms in Dental Hospital Worker (치과병원 종사자에서 측두하악관절장애 증상에 따른 삶의 질 평가)

  • Kim, Dong-Kook;Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.61-72
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    • 2012
  • Temporomandibular disorder(TMD) is relatively prevalent disease, and quality of life may be impaired in TMD patients. Like general population, dental hospital workers are also exposed to the risk of TMD. But, many of them tend to overlook or tolerate their symptoms for lack of time and interest. Therefore, problems may become more serious, causing interference of performing task and decrease of quality of life. The aim of this study were to obtain data for TMD prevalence in dental hospital workers and to evaluate quality of life according to TMD symptoms. Subjects were recruited from Wonkwang University Dental Hospital. After consent, subjects completed quality of life questionnaire and were evaluated for subjective and objective signs and symptoms of TMD. Subjects were classified into 4 groups : (1) normal group (2) joint disorder group, (3) local myalgia group, and (4) myofascial pain group. The result of the study indicated that TMD negatively influences the quality of life in dental hospital worker. TMD symptoms can deteriorate quality of life in dental hospital worker. Future effort to make protocol for proper management is needed.

Incidence of hearing loss and importance of risk factors in the neonatal intensive care unit (신생아 중환자실에서 난청의 발생빈도 및 위험요소의 중요성)

  • Kong, Seung Hyun;Kang, Jang Hee;Hwang, Kwang Su;Kim, Joong Pyo;Lee, Hyeon Jung;Choi, Hyeon;Mok, Ji Sun;Kim, Jung Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.845-850
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    • 2006
  • Purpose : To assess the incidence of neonatal hearing loss in a neonatal intensive care unit and the relative importance of risk factors for hearing imparement in a neonatal intensive care unit which the Joint Committee on Infant Hearing(JCIH) had recommended. Methods : One thousand, two hundred and one newborns admitted to the Good Moonhwa Intensive Care Unit from May 2003 to December 2005 were assesed using the automated auditory brainstem response(AABR). The screening was performed on those aged more than 36 weeks and weighing more than 2,200 g. We divided the infants into two groups, 'pass' and 'refer'. The 'refer' group were retested one month later, and if classified as 'refer' during the retest, were referred to a hearing impairment clinic. Results : From the 1,201 neonates, 1,187(98.8 percent) passed the test and 14(1.2 percent) failed. 293(24.4 percent) of the 1,201 neonates had a risk factor for hearing impairment; 282(96.2 percent) passed the test and 11(3.8 percent) failed. The group with risk factors were shown to have a higher incidence of hearing loss(P<0.001). The neonates in the refer group were shown to have a higher incidence of ototoxic drugs(P<0.001), low birth weight(<1,500 g)(P<0.001) and craniofacial anomalies(P=0.007). On the other hand, there were no statistical differences between the pass and refer groups in congenital infection, hyperbilirubinemia, bacterial meningitis, low Apgar scores, prolonged mechanical ventilation and syndromes known to include hearing loss. Conclusion : In order to identify hearing-impaired infants within an appropriate period, neonatal hearing screening tests and identification of the risk factors for neonatal hearing loss are important.

Interrelationship of Tension-type Headache and Oral Parafunction (긴장성 두통과 이갈이 습관의 상호관계)

  • Huh, Ki-Hwei;Kim, Jin-Suk;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.79-85
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    • 2005
  • This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. 1. There was no difference in sex(p=0.91) and age(p=0.73) between two groups. 2. In the experimental group, dull pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.69). 3. In the experimental group, severe pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.40). 4. In the experimental group, pain shown bilaterally was presented more frequently than in the control group. But, there was no difference between two groups(p=0.52). 5. In the experimental group, pain was more increased by physical activities than in the control group. But, there was no difference between both groups(p=0.74). The pain of TTH patients with OPF was presented to be non-dull pain frequently and more bilaterally and severely, also increased more by physical activities than the pain of TTH patients without OPF. But, there was no significant difference between two groups. Therefore, it is considered that the pain of TTH is not influenced by OPF.

The Variation of Natural Population of Pinus densiflora S. et Z. in Korea(I) -Characteristics of Needle and Wood of Chuwang-san, An-Myeon-do and Odae-san Populations- (소나무 천연집단(天然集團)의 변이(變異)에 관(關)한 연구(硏究)(I))

  • Yim, Kyong-Bin;Kim, Zin-Suh
    • Journal of Korean Society of Forest Science
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    • v.28 no.1
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    • pp.1-20
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    • 1975
  • F$\ddot{u}$r die Erforschllng der Variationen bei der Naturpopulationen der Pinus densifiora wurden drei Populationen aus Chuwangsan (Kyong-buk), Anmyondo (Chung-nam) und Odaesan (Kangwon) Ausgewiiblt. Bei je 20 Individuen jeder Population wurden die Variationen von der Eigenschaft der $\ddot{a}$usseren Gestalt, von der anatomischen und morphologischen Eigenschaft der Kiefernadel und von der Holzqualit$\ddot{a}$t an Bohrsp$\ddot{a}$nen untersucht. Das Ergebnis der Untersuchung konnte in den folgenden sechs Punkten formuliert werden. 1. Von den Eigenschaften der $\ddot{a}$usseren Gestalt ist die Geradheit des Baumstamms, der Durchmesser der Zweige und der Winkel der Verzweigung in der Odaesan Population wlinschenswerter als in anderen Populationen. 2. Es wird festgestellt, dass sich die drei Nadelmerkmale, Anzahl der Z$\ddot{a}$hne je 0.5 cm, Anzahl der Stomata-Reihen und Anzahl der Harzkan$\ddot{a}$le, sowohl zwischen den Populationen als auch zwischen den Individuen signignifikant unterscheiden. 3. Bei der Betrachtung des Harzkanal Index, der Schichtanzahl der Hypodermis und der Entfernung der Fibrovasalb$\ddot{u}$ndel wird aufgezeigt, dass sich alle drei gepr$\ddot{u}$ften Populationen geringf$\ddot{u}$gig von der normalen Kiefer unterscheiden. 4. Zwischen den Populationen ergibt sich ein Unterschied im Prozentanteil des Spatho lzes und im spezifischen Geswicht, jedoch zeigt die Breite der Jahresrings und die Tracheidenl$\ddot{a}$nge keinen Unterschied. Das spezifische Gewicht und die Tracheidenl$\ddot{a}$nge der Individuen jeder Population ist signifikant verschieden. 5. Bei dem Alter 11-20 ist der Prozentanteil des sp$\ddot{a}$tholzes am gr$\ddot{o}$ssten und wird aber danach immer geringer bis zum Alter 30; sp$\ddot{a}$ter zeigt sich dann keine sichtbare Ver$\ddot{a}$nderung mehr. Das spezifische Gewicht sich vergr$\ddot{o}$ssert bei der Zunahme des Jahresrings, nimmt aber dann in Anmyondo und Odaesan Populationen beim Alter 21-30 wieder ab. Die Tracheidenl$\ddot{a}$nge der drei Populationen besitzen die Neigung, sich nach der zunahme der Jahresringe zu vermehren. 6. Mit diesen hier behandelten Charakteren werden ganz allgemeinen die Unterschiede der drei Kiefer populationen festgestellt. Diese Ergebnisse sind sehr bemerkenswert betrachtet vom genetischen Gesichtspunkt der waldbaumpopulation.

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Association Between Temporomandibular Disorders and Cervical Muscle Pressure Pain (측두하악장애와 경부근육 압통 간의 상관성)

  • Im, Yeong-Gwan;Kim, Jae-Hyeong;Kim, Byung-Gook
    • 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.

Cephalometric study on head posture according to the Classification of Malocclusion (부정교합 분류에 따른 두경부 위치의 두부방사선 계측학적 연구)

  • Hwang, Chung-Ju;Kim, Suk-Hyun;Kil, Jae-Kyung
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.221-230
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    • 1997
  • It has been known that head posture may influence directly and/or indirectly the growth and development of craniofacial morphology and can also be influenced by the funtional demand of physiologic activity. It was reported that facial morphology has close relationships with hyoid bone position and head posture. In many previous studies, Natural Head Posture(NHP) was guided, and also it was shown that NHP has high degree of reproducibility. Otherwise, There was few study about the relationship of head posture, with routine cephalometric film which is used for clinical orthodontic purpose. In this study, according to the Wits and ANB of initial cephalometric film which was taken with vertical pendulum as representative of true vertical reference line. We classified the subjects which is comprised of 60 adult female patients into Class I, II, III (Cl I, II, III)and we tried to find out the correlation of head posture and hyoid bone position according to the classification of malocclusion. As a result of our research, we found the followigs. 1. In comparison of vertical position of hyoid bone relative to the cranial base. the position of hyoid bone of Cl III was lower than that of Cl II. 2. In comparison of anteriorpostes or position of hyoid bone, relative to the cervical column. The position of hyoid bone of Cl III was more anterior than that of a II 3. in comparison of vertical position of hyoid bone relative to mandible. There was no significant correlation aumoug the groups of malocclusion. 4. ANB and Wits showed no significant correlation with hyoid bone position. 5. The relative extension of head, which was noted in Cl II, showed negative with Sum, ANB. 6. In Cl II and Cl III, Post to Ant facial height showed positive correlation with NSL/VER.

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